儿童神经母细胞性肿瘤超声特征分析  

The characteristics of ultrasonographic features of neuroblastic tumor in children

作　　者：冯蔚 王峥嵘[1] 苏英姿[1] 张薇薇[1] 任红雁[1] 刘琴[1] 张勇[1] 李贺云 马亚 Feng Wei;Wang Zhengrong;Su Yingzi;Zhang Weiwei;Ren Hongyan;Liu Qin;Zhang Yong;Li Heyun;Ma Ya(Department of Ultrasound,Children′s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院超声科,北京100020

出　　处：《中华超声影像学杂志》2020年第11期969-976,共8页Chinese Journal of Ultrasonography

摘　　要：目的探讨儿童节细胞神经瘤(GN)、节细胞神经母细胞瘤混合型(GNBi)、节细胞神经母细胞瘤结节型(GNBn)、神经母细胞瘤(NB)的超声表现特点,提高超声诊断四种神经母细胞性肿瘤的准确性。方法回顾分析2014年6月至2019年2月于首都儿科研究所附属儿童医院经术后病理证实的279例神经母细胞性肿瘤(23例GN,44例GNBi,86例GNBn,126例NB)患儿资料,总结超声表现,并与病理对照。结果中位年龄:GN组6.9岁,GNBi组3.9岁,GNBn组3.0岁,NB组2.0岁。血清神经元特异性烯醇化酶(NSE)中位值:GN组6.3μg/L,GNBi组9.6μg/L,GNBn组22.6μg/L,NB组40.7μg/L。GN组无远处转移,9%GNBi、26%GNBn、36%NB存在远处转移;GN组、GNBi组无邻近组织器官侵犯,9%GNBn、15%NB侵犯邻近组织器官;91%GN、70%GNBi、58%GNBn病灶包膜完整,NB组病灶44%包膜不完整、28%无包膜;96%GN、57%GNBi呈类圆或椭圆形,57%GNBn、60%NB形态不规则;96%GN内呈均匀低回声,75%GNBi内呈"云雾状"不均匀回声,59%GNBn、75%NB病灶内见高回声结节或呈多结节融合状;65%GN内见小斑点、片状钙化,27%GNBi、29%GNBn、25%NB内见粗大钙化;100%GN、91%GNBi、91%GNBn内呈少-中量血流,33%NB内丰富血流;4%GN、41%GNBi、51%GNBn、49%NB包绕血管;13%GN、5%GNBi、6%GNBn、8%NB侵入椎管;GN无淋巴结转移,48%GNBi、59%GNBn、56%NB存在淋巴结转移。结论GN与GNBi、GNBn、NB超声表现差异较大,后三者超声表现有一定差异,但部分难以鉴别。Objective To discuss the ultrasonographic features of ganglioneuroma(GN), ganglioneuroblastoma-intermixed(GNBi), ganglioneuroblastoma-nodular(GNBn), neuroblastoma(NB) in children and to improve the ultrasound diagnostic accuracy of four kinds of neuroblastic tumors.Methods Two hundred and seventy-nine patients with neuroblastic tumors(23GN, 44GNBi, 86GNBn, 126NB) confirmed by surgery and pathological diagnosis in Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2014 to February 2019 were retrospectively analysed. The ultrasonographic data were summarized and compared with pathological results.Results The median age were 6.9 years in GN group, 3.9 years in GNBi group, 3.0 years in GNBn group and 2.0 years in NB group. The median values of serum neuron-specific enolase(NSE) were 6.3 μg/L in GN group, 9.6 μg/L in GNBi group, 22.6 μg/L in GNBn group and 40.7 μg/L in NB group respectively. There was no distant metastasis of GN, while 9% GNBi, 26% GNBn and 36% NB had distant metastasis;GN and GNBi group had no invasion to adjacent tissues and organs, while 9% GNBn and 15% NB lesions had invasion to adjacent tissues and organs;91% GN, 70% GNBi, 58% GNBn lesions had complete capsule, while 44% NB lesions had incomplete capsule and 28% NB had no capsule;96%GN, 57%GNBi lesions were round or oval, while 57%GNBn, 60%NB lesions showed irregular shape;96%GN showed homogeneous hypoechoic, 75% GNBi had "cloudy" inhomogeneous echoe, while hyperechoic nodules were seen in 59% GNBn and 75% NB lesions;65%GN lesions contained discrete and punctate calcifications, while 27%GNBi, 29%GNBn, 25%NB lesions contained coarse calcifications;100%GN, 91%GNBi, 91%GNBn lesions had little to moderate blood flow, while 33%NB lesions had abundance blood flow;4%GN, 41%GNBi, 51%GNBn, 49%NB lesions surrounded blood vessels;13%GN, 5%GNBi, 6%GNBn, 8%NB lesions had spinal canal invasion;GN had no lymph node metastasis, but 48%GNBi, 59%GNBn, 56%NB lesions had lymph node metastasis.Conclusions The ultrasonographic characteri

关 键 词：超声检查 节细胞神经瘤 节细胞神经母细胞瘤 节细胞神经母细胞瘤结节型 神经母细胞瘤 儿童 

分 类 号：R739.4[医药卫生—肿瘤] R445.1[医药卫生—临床医学]