低剂量CT在小儿肾母细胞瘤诊断中的应用和影像学表现  

Application and imaging findings of low-dose CT in the diagnosis of nephroblastoma in children

作　　者：罗韦华[1] 李群艳[1] LUO Wei-Hua;LI Qun-Yan(Hunan Children's Hospital,Changsha,Hunan 410007,China)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《中国妇幼保健》2022年第8期1521-1524,共4页Maternal and Child Health Care of China

基　　金：湖南省自然科学基金项目(2018JJ3271)。

摘　　要：目的 探讨低剂量CT在小儿肾母细胞瘤诊断中的应用和影像学表现。方法 选取2016年9月—2019年10月在湖南省儿童医院就诊的疑似肾母细胞瘤患儿74例为研究对象,随机分为对照组和观察组,每组各37例,对照组患儿施以常规剂量CT,观察组患儿施以低剂量CT,比较两组患儿图像质量、确诊率,分析低剂量CT诊断小儿肾母细胞瘤的影像学表现。结果 两组患儿图像质量评分比较,差异无统计学意义(P>0.05),且观察组患儿图像评分均达3分及以上,符合诊断要求。对照组患儿经病理诊断确诊35例,确诊率为94.6%,其中有6例为多囊肾、29例为肾母细胞瘤,共2例误诊;观察组患儿经病理诊断确诊34例,确诊率为91.9%,其中有9例为多囊肾,25例为肾母细胞瘤,共3例误诊。两组患儿确诊率比较,差异无统计学意义(P>0.05)。观察组经病理诊断确诊共25例为肾母细胞瘤,其中2例(8.0%)为葡萄束状,表现呈肾窦区肿块,边缘清晰,密度较低,与肾实质边界模糊,两者之间存在囊样低密度影,最长可延伸至膀胱内;19例(76.0%)为实质性肿块、2例(8.0%)为囊性肿块、4例(16.0%)为囊实性肿块;2例(8.0%)钙化、8例(32.0%)出血、15例(60.0%)伴坏死;残肾在肿瘤周边表现为半环形,所有确诊患者均出现肾盏、肾盂扩张、变形、分离及移压等变化,其中有8例(32.0%)肾盏、肾盂受损;平扫发现8例(32.0%)患者肿瘤密度低于正常的肾实质。结论 在诊断小儿肾母细胞瘤的过程中,施以低剂量CT在确保图像质量的同时也不会降低确诊率,可在临床上广泛推广应用。Objective To investigate the application and imaging manifestations of low dose CT in the diagnosis of nephroblastoma in children.Methods 74 children suspected of nephroblastoma admitted to Hunan Children’s Hospital from September 2016 to October 2019 were selected as the research objects and randomly divided into control group and observation group, with 37 cases in each group.Children in the control group received conventional dose CT, and children in the observation group received low-dose CT.Image quality and diagnosis rate of the two groups were compared.To analyze the imaging features of low dose CT in the diagnosis of pediatric nephroblastoma.Results There was no significant difference in image quality scores between the two groups(P>0.05), and the image scores of the observation group were all 3 points or above, which met the diagnostic requirements.In the control group, 35 cases were diagnosed by pathological diagnosis, with a diagnosis rate of 94.6%, including 6 cases of polycystic kidney disease and 29 cases of nephroblastoma, 2 cases of misdiagnosis.In the observation group, 34 cases were diagnosed by pathological diagnosis, with a diagnosis rate of 91.9%, including 9 cases of polycystic kidney disease and 25 cases of nephroblastoma, and 3 cases were misdiagnosed.There was no significant difference in the diagnosis rate between the two groups(P>0.05).In the observation group, a total of 25 cases were diagnosed as nephroblastoma by pathological diagnosis, of which 2 cases(8.0%) were bunchy, presenting as renal sinus mass with clear margin, low density, and blurred boundary with renal parenchyma.There was cystic hypodensity shadow between them, extending to the bladder as long as possible.19 cases(76.0%) were solid masses, 2 cases(8.0%) were cystic masses, and 4 cases(16.0%) were cystic solid masses.Calcification in 2 cases(8.0%), hemorrhage in 8 cases(32.0%) and necrosis in 15 cases(60.0%).The residual kidney was semicircle in the periphery of the tumor, and all confirmed patients showed dilation, de

关 键 词：低剂量CT 小儿肾母细胞瘤 诊断 影像学表现 

分 类 号：R737.1[医药卫生—肿瘤]