儿童肾横纹肌样瘤的CT诊断与鉴别诊断  

CT diagnosis and differential diagnosis of rhabdoid tumor of kidney in children

作　　者：肖伟强 刘鸿圣 刘振清 吴倩倩 XIAO Wei-qiang;LIU Hong-sheng;LIU Zhen-qing;WU Qian-qian(Department of Radiology,Guangzhou Women and Children’s Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心放射科,广东广州510623

出　　处：《中国临床医学影像杂志》2022年第1期24-27,共4页Journal of China Clinic Medical Imaging

基　　金：广东省自然科学基金面上项目(2020A1515010164)。

摘　　要：目的:探讨儿童肾横纹肌样瘤(RTK)的影像学特点,旨在提高对该病的认识和诊断水平。方法:搜集广州市妇女儿童医疗中心2009年9月—2021年4月经病理及免疫组化证实为RTK患儿共35例临床及影像资料行回顾分析,其中男22例,女13例;年龄1~71月。结果:本组RTK影像特点:瘤内出血12例(34.29%,12/35)、坏死31例(88.57%,31/35)、囊变9例(25.71%,9/35);钙化12例(34.29%,12/35);包膜下积液12例(34.29%,12/35)。增强其实质部分呈不均匀轻中度强化,坏死及囊变区不强化。其中3例(8.57%)为多部位生长,转移13例(37.14%,13/35),术后复发3例(8.57%,3/35)。结论:RTK的钙化、包膜下积液等影像学表现较具特点,结合其全身多发、容易转移和复发等特性,有助于RTK的诊断。Objective:To investigate the radiographic features of rhabdoid tumors of kidney(RTK)in children,aiming to improve the understanding and diagnosis of RTK.Methods:The clinical and radiographic data of 35 children with RTK which proved by pathology and immunohistochemistry from September 2009 to April 2021 were retrospectively analyzed,including 22 males and 13 females,aged from 1 to 71 months.Results:The radiographic features of the RTK in this group:intratumoral hemorrhage were showed in 12 cases(34.29%,12/35),necrosis in 31 cases(88.57%,31/35),cystic degeneration in 9 cases(25.71%,9/35),calcification in 12 cases(34.29%,12/35),subcapsular effusion in 12 cases(34.29%,12/35).Contrast Enhacement:The parenchyma parts of the tumors were showed heterogeneous mild to moderate enhancement,and the necrosis and cystic parts were not enhanced.Among them,3 cases(8.57%,3/35)had multiple sites,13 cases(37.14%,13/35)had metastasis,3 cases(8.57%,3/35)recurred after surgery.Conclusion:The imaging features of RTK such as calcification and subcapsular effusion are more characteristic,combined with the aggressive characteristics such as multi-sites,metastasis and recurrence,are helpful to the diagnosis of RTK.

关 键 词：肾肿瘤 横纹肌瘤 儿童 体层摄影术 螺旋计算机 诊断 鉴别 

分 类 号：R737.11[医药卫生—肿瘤] R730.262[医药卫生—临床医学]