儿童胸膜肺母细胞瘤CT影像学特征分析  

CT Imaging Features of Pleuropulmonary Blastoma in Children

作　　者：李春旺 李殊明 汤静 LI Chunwang;LI Shuming;TANG Jing(Hunan Children's Hospital,Affiliated Children's Hospital,Xiangya School of Medicine,Central South University,Changsha Hunan 410007)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院),湖南长沙410007

出　　处：《医学临床研究》2024年第10期1468-1471,共4页Journal of Clinical Research

基　　金：湖南省临床医疗技术创新引导项目(2021SK50511)。

摘　　要：【目的】分析儿童胸膜肺母细胞瘤(PPB)的CT影像学特征。【方法】回顾性分析湖南省儿童医院放射科2016年8月至2022年7月收治的10例经穿刺活检或手术病理证实为PPB的患儿临床及CT影像学资料,所有病例均行CT平扫及增强扫描。其中,男5例,女5例;年龄为1岁2个月~4岁11个月,中位年龄3岁2个月。患儿主要因发热、咳嗽、气促、胸痛等非特异性呼吸道感染症状就诊。【结果】10例PPB患儿均为单发,右侧6例、左侧4例。10例中Ⅰ型1例,Ⅱ型2例,Ⅲ型7例。8例肿块位于肺外围,向健侧推压肺组织及纵隔,1例位于肺叶内,1例位于肺门周围。肿瘤直径均大于6.5 cm,其中6例肿块几乎占满半侧胸腔。1例合并左肾囊性肾瘤。CT表现:Ⅰ型表现为多房囊性肿块,囊内充满液体并含有少量气体,囊内分隔可见强化;Ⅱ型为囊实性肿块,平扫实性部分为软组织密度,有不均匀轻度强化,囊性部分无强化;Ⅲ型为纯实性肿块,表现为边界较清楚、强化不均匀的肿块,其内可见多发肿瘤滋养血管。所有病例中均未见肋骨破坏及纵隔淋巴结肿大,伴或不伴有少量胸腔积液,仅2例见少许钙化灶。【结论】2~4岁患儿CT发现一侧胸腔紧贴胸壁的巨大肿块,但胸壁未见明显受累,肋骨无骨质破坏,应首先考虑到PPB的可能。【Objective】To analyze the CT imaging features of pleuropulmonary blastoma(PPB)in children.【Methods】Clinical and CT imaging data of 10 children with PPB confirmed by puncture biopsy or surgical pathology admitted to the Department of Radiology of Hunan Children's Hospital from August 2016 to July 2022 were retrospectively analyzed.All cases underwent plain and enhanced CT scan.Among them,5 were male and 5 were female.The ages ranged from 1 year 2 months to 4 years 11 months,with a median age of 3 years 2 months.The main symptoms of non-specific respiratory tract infection were fever,cough,shortness of breath and chest pain.【Results】All the 10 cases were single,6 cases on the right side and 4 cases on the left side.Among the 10 cases,1 case was typeⅠ,2 cases were typeⅡ,and 7 cases were typeⅢ.In 8 cases,the masses were located in the periphery of the lung and pressed the lung tissue and mediastinum to the healthy side,1 in the lung lobe and 1 around the lung hilum.The tumors were all larger than 6.5 cm in diameter,and in 6 cases,the mass occupied almost half of the thoracic cavity.One case was complicated with left renal cystic tumor.CT findings:TypeⅠpresented as a multilocular cystic mass filled with fluid and containing a small amount of gas.TypeⅡwas a solid cystic mass with soft tissue density in the plain scan,uneven mild enhancement,and no enhancement in the cystic mass.TypeⅢwas a pure solid mass with clear boundaries,uneven enhancement,and multiple tumor-nourishing vessels.Rib destruction and mediastinal lymph node enlargement were not observed in all cases,with or without a small amount of pleural effusion,and only 2 cases had a small amount of calcification.【Conclusion】In children aged 2 to 4 years old,CT found a huge mass close to the chest wall on one side of the chest,but no obvious involvement in the chest wall and no bone destruction of the ribs.The possibility of PPB should be considered first.

关 键 词：肺肿瘤/影像诊断 胸膜肿瘤/影像诊断 儿童 体层摄影术 螺旋计算机 

分 类 号：R734.2[医药卫生—肿瘤]