儿童肾脏横纹肌样瘤的CT诊断价值  

CT diagnostic value of rhabdoid tumor of the kidney in children

作　　者：吕星星 韩素芳[1] 朱美娇 徐化凤[1] LüXingxing;HAN Sufang;ZHU Meijiao;XU Huafeng(Department of Radiology,Children’s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,江苏南京210008

出　　处：《实用放射学杂志》2021年第12期2043-2046,共4页Journal of Practical Radiology

摘　　要：目的分析儿童肾脏横纹肌样瘤(RTK)的CT表现,提高对该病的认识。方法回顾性分析经手术及病理证实的8例RTK的临床及CT影像资料。结果左肾5例,右肾3例,均靠近肾门;4例体积较大,直径>10 cm,其中2例跨越中线;病灶均呈实性且具有包膜,伴不同程度囊变、坏死;7例肿瘤包膜不完整,其中5例可见瘤体突破局部包膜向周围浸润;6例内部见出血;3例见点状钙化;2例合并包膜下积液。增强后实体部分强化不均匀,4例皮质期明显强化,4例皮质期轻至中度强化,7例实质期均有不同程度进一步强化。3例术前两肺见胸膜下结节灶,5例术后出现肺内、肝脾或腹部转移灶。结论儿童RTK影像学表现为位于肾门附近的常伴出血坏死的肿块,增强后明显不均匀强化;肿瘤突破局部包膜向周围浸润或合并包膜下积液较具特征性。Objective To analyze the CT manifestations of rhabdoid tumor of the kidney(RTK)in children,to improve the understanding of this disease.Methods The clinical and CT imaging data of 8 cases with RTK confirmed by surgery and pathologically were analyzed retrospectively.Results 5 cases located in the left kidney,3 in the right kidney,all close to the renal hilum;4 cases were large in volume with a diameter more than 10 cm,of which 2 crossed the midline.All the lesions were solid with capsule and cystic necrosis of different degrees.The tumor capsule was incomplete in 7 cases,of which 5 cases had wall infiltration through the local capsule;6 cases had internal hemorrhage and 3 cases had punctate calcification jsubcapsular effusion was found in 2 cases.After enhancement,the solid part of enhancement was uneven.4 cases presented obvious enhancement on the corticomedullary phase,the other 4 cases showed mild to moderate enhancement,and 7 cases showed further enhancement on the nephrographic phase to various degrees.Subpleural nodules were found in both lungs in 3 cases before surgery,and metastasis in lungs,liver,spleen or abdomen were found in 5 cases after surgery.Conclusion The imaging manifestations of RTK are the mass with hemorrhage and necrosis located near the hilum of the kidney,and the enhancement is significantly heterogeneous.Tumor breaking through the local capsule to the surrounding invasion or combined with subcapsular effusion is more typical.

关 键 词：儿童 肾肿瘤 横纹肌样瘤 计算机体层成像 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]