新生儿神经母细胞瘤的影像学表现  

Imaging Features of Neuroblastoma in Neonates

作　　者：杨双风 高军[1] 李航[1] 唐晓璐[1] 杨利新[1] 彭芸[1] YANG Shuangfeng;GAO Jun;LI Hang;TANG Xiaolu;YANG Lixin;PENG Yun(Department of Radiology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院,影像中心,北京100045

出　　处：《中国医学影像学杂志》2021年第10期1028-1034,共7页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金面上项目(81671651)。

摘　　要：目的分析新生儿神经母细胞瘤的临床与影像学特征,提高对本病的认识。资料与方法回顾性纳入31例新生儿神经母细胞瘤患儿(29例经手术病理证实,2例结合临床、实验室检查及影像学检查诊断),29例行CT检查,5例行MRI检查,分析其CT及MRI特征。结果31例患儿中,男15例,女16例;病变检出年龄孕27周~出生后28 d,中位孕周39周。原发肿瘤为实性20例,囊实性11例。原发肿瘤部位:肾上腺22例,腹膜后3例,咽部3例,后纵隔2例,颈部2例,骶尾部1例,其中2例为多中心病灶。CT平扫示瘤体密度多不均匀,13例伴钙化;MRI平扫示5例肿瘤均为混杂信号,1例伴囊变坏死,1例伴钙化。实性部分均呈不均匀强化,8例肿瘤伴出血,9例包绕大血管,3例侵犯椎管。9例发生肝转移,其中1例伴有皮肤及下颌骨转移。结论新生儿神经母细胞瘤以肾上腺起源者多见,多为实性或囊实性不均质强化肿块,可伴出血、钙化,远处转移部位以肝脏最常见。Purpose To demonstrate the clinical and imaging features of neuroblastoma in neonates and to raise awareness of the disease.Materials and Methods Clinical and imaging data of 31 patients with neonatal neuroblastoma were retrospectively analyzed.The CT and MRI examinations were performed in 29 and 5 cases,respectively.Results The patients included 15 males and 16 females.Twenty-nine cases were confirmed by surgery and pathology,2 cases were diagnosed by clinical,laboratory and imaging examinations.The age at presentation varied from 27 weeks gestation to 28 days after birth with a median age of 39 weeks gestation.The primary tumors were solid in 20 cases and cystic-solid in 11 cases.The primary sites of the tumors were as follows:adrenal gland in 22 cases,peritoneum in 3 cases,pharynx in 3 cases,posterior mediastinum in 2 cases,the neck in 2 cases and the sacrococcygeal in 1 case,2 of which were multi-centric lesions.On CT,density of most tumors were all heterogeneous,13 cases were with calcification.On MRI,there were 5 cases with mixed signal,1 case with cystic change,and 1 case with calcification.The solid part showed predominantly heterogeneous enhancement.There were 8 cases with definite hemorrhage within tumors,9 cases with surrounding large blood vessels,3 cases with invading the spinal canal.Distant metastasis to the liver occurred in 9 cases,including 1 case with skin and mandibular metastasis.Conclusion Neonatal neuroblastoma is more common in the adrenal glands,most of which are solid or cystic and solid masses with heterogeneous enhancement,sometimes with hemorrhage and calcification.The liver is the most common site of distant metastasis.

关 键 词：神经母细胞瘤 体层摄影术 X线计算机 磁共振成像 病理学 外科 新生儿 

分 类 号：R730.42[医药卫生—肿瘤] R722.19[医药卫生—临床医学]