儿童肾恶性横纹肌样瘤的CT、MRI表现  

CT and MRI Imaging Findings of Malignant Rhabdoid Tumor of the Kidney in Children

作　　者：刘思讪 付金花 LIU Si-shan;FU Jin-hua(Department of Radiology,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Radiology,Shanghai Children's Hospital,Shanghai Children's Hospital Affliated to School of Medicine of Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属市中医医院放射科,上海200071 [2]上海市儿童医院、上海交通大学附属儿童医院影像科,上海200062

出　　处：《中国CT和MRI杂志》2024年第8期92-94,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨儿童肾恶性横纹肌样瘤的CT、MRI表现,以提高该病的影像诊断水平。方法回顾性分析上海市儿童医院2008年5月~2021年3月经病理证实8例肾恶性横纹肌样瘤的患者资料。7例患儿行CT平扫及增强检查,4例患儿行磁共振平扫及增强检查,观察分析肾恶性横纹肌样瘤体的部位、形态、大小、密度/信号特征、强化方式以及转移等。结果6例位于左肾,2例位于右肾,2例病变呈圆形或类圆形,6例为不规则形,6例累及肾窦、肾盂。CT平扫中5例呈稍高密度,2例呈等低密度,肿瘤最大径平均约8.6cm;2例合并出血,3例合并包膜下积液/积血,8例均合并囊变坏死。MRI平扫中4例T1WI呈低信号为主,3例T2WI呈稍高信号,1例T2WI呈混杂信号。2例病变DWI均呈明显高信号、相应ADC为低信号,提示病变弥散受限。增强后呈不均匀轻度强化。5例伴转移。结论儿童肾恶性横纹肌样瘤CT、MRI表现有特征性,儿童肾实质内巨大肿块,合并囊变坏死、出血,集合系统受累,伴有包膜下积液,弥散受限,增强扫描实性成分轻度强化,常合并转移,应高度警惕肾恶性横纹肌样瘤的可能。Objective To investigate the CT and MR imaging features of Children Malignant rhabdoid tumor of kidney(MRTK)in children.Methods 8 cases of MRTK confirmed pathologically in Shanghai Children's Hospital from May 2008 to March 2021 were analyzed retrospectively.All 7 cases underwent plain and enhanced CT and 4 cases underwent plain and enhanced MRI.We observed and analyzed the location,shape,size,density/signal,enhancement pattem,and the metastasis of the tumor.Results 6 cases occurred in the left kidney and 2 cases in the right kidney.2 cases in MRTK were round or ellipse and 6 cases was irregular shape.Renal pelvis was invaded in 6 cases.5 cases were iso-or slightly hyperdensity and 2 cases such as density on CT scans,The tumor average maximum diameter is about 8.6cm;2 cases with bleeding.The renal capsule/sub capsule effusion/hemorrhage was in 3 cases,8 cases were merged cystic necrosis.T1WI signals of 4 cases were low or equal to the renal cortex on MRI scans,T2WI signals of 3 cases were high or equal to the renal cortex and 1case was mixed signal.2cases with high signal on DWI and low signal on ADC.All cases were slightly enhanced.5 cases with metastasis.Conclusion MRTK have characteristic imaging findings,especially Children in the renal parenchyma mass,including the lesion with Punctate and patchy calcifications.With merge bleeding,high signal on DWI and low signal on ADC,with mild to moderate enhancement.May need to be mindful of the disease.

关 键 词：儿童 计算机断层扫描 磁共振 肾恶性横纹肌样瘤 

分 类 号：R339.31[医药卫生—人体生理学] R445[医药卫生—基础医学]