小儿腹膜后畸胎瘤的CT与MRI表现特征及其诊断价值  

Diagnostic Value of CT and MRI in Children with Retroperitoneal Teratoma

作　　者：王孝勇 陈新亚 周彦娟 WANG Xiaoyong;CHEN Xinya;ZHOU Yanjuan(The Affiliated Children's Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学附属儿童医院,450000

出　　处：《实用癌症杂志》2022年第3期501-504,共4页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190382)。

摘　　要：目的分析小儿腹膜后畸胎瘤的CT与MRI表现特征及诊断价值。方法随机选择小儿腹膜后畸胎瘤患儿62例,分别使用CT与MRI诊断。比较确诊情况、肿瘤位置正确检出情况,分析CT和MRI表现特征,判断联合诊断价值。结果CT确诊45例、MRI确诊49例、联合诊断确诊60例,CT+MRI联合确诊率高于单纯CT、单纯MRI(P<0.05)。单纯CT、MRI和联合CT+MRI在肿瘤位置中左肾前方、右肾前方、双肾及腹主动脉直达前腹壁的正确检出率相同,差异比较无统计学意义(P>0.05);在骶尾部、其他部位的正确检出率上差异比较有统计学意义(P<0.05),其中正确检出率最高的是联合CT+MRI。一般CT表现为肿瘤直径为50~186 mm,平均为120 mm;肿瘤形态各异,主要有53例呈类圆形,其中30例呈椭圆形,伴有分叶征,但具有完整包膜。一般MRI显示囊性区呈现均匀T1和T2长信号;脂肪信号稍短T3信号,但T2信号延长;囊壁和间隔呈等T1信号和T2等信号;钙化病灶则为长T1信号和短T2信号。12例患儿出现囊实性改变,病理为成熟良性,表现为混杂密度和信号。STIR序列呈低信号改变,3例患儿内见脂肪信号。18例患儿肿瘤出现双底信号钙化改变。病灶直径13~189 mm,平均104 mm。联合诊断价值最高,明显高于单纯CT或MRI(P<0.05)。结论小儿腹膜后畸胎瘤的CT与MRI特征存在不同,联合应用能提升诊断价值。Objective To analyze the CT and MRI features and diagnostic value of retroperitoneal teratoma in children.Methods 62 children with retroperitoneal teratoma were randomly selected.CT and MRI were used respectively.The diagnosis and location of the tumor were compared,and the CT and MRI manifestations and features were analyzed to judge the value of combined diagnosis.Results 45 cases were diagnosed by CT,49 cases by MRI and 60 cases by combined diagnosis.The diagnosis rate of CT+MRI was the highest,which was higher than that of CT and MRI alone(P<0.05).There was no significant difference between CT,MRI and combined CT+MRI in the correct detection rate of tumors in front of left kidney,front of right kidney,both kidneys and abdominal aorta(P>0.05),but there was significant difference in the detection rate of sacrococcygeal and other tumors(P<0.05).The average diameter of the tumor was 120 mm(range,50-186 mm).There were 53 cases with round shape,30 cases with oval shape and lobulated sign,but with complete capsule.MRI generally showed homogeneous T1 and T2 long signal in cystic area.Fat signal was slightly shorter than T3 signal,but T2 signal was longer.The cystic wall and septum showed equal T1 and T2 signals.Calcified lesions showed normal T1 signal and short T2 signal.Cystic and solid changes were found in 12 cases.The pathology was mature and benign,showing mixed density and signal.STIR sequence showed low signal change,fat signal was found in 3 cases.The double bottom signal calcification was found in 18 cases.The diameter of the lesions ranged from 13 mm to 189 mm,with an average of 104 mm.The value of combined diagnosis was the highest,which was significantly higher than that of CT or MRI alone(P<0.05).Conclusion The CT and MRI features of retroperitoneal teratoma in children are different,the combined use can improve the diagnostic value.

关 键 词：小儿 腹膜后畸胎瘤 CT MRI 诊断 价值 

分 类 号：R735.5[医药卫生—肿瘤]