平扫CT在小儿结节性硬化症诊断中的应用  

Application of plain Scan CT in the diagnosis of tuberous sclerosis complex in children

作　　者：江蒙杰 张培华 陈巧菊 JIANG Mengjie;ZHANG Peihua;CHEN Qiaoju(Department of Radiology,Kaifeng Children's Hospital,Kaifeng 475000,China)

机构地区：[1]开封市儿童医院影像科,河南开封475000

出　　处：《黑龙江医药科学》2025年第1期61-63,66,共4页Heilongjiang Medicine and Pharmacy

基　　金：河南省自然科学基金项目,编号:20190259。

摘　　要：目的:探究平扫CT在小儿结节性硬化症疾病中的诊断效果。方法:选取开封市儿童医院影像科2019年1月至2022年1月收治的80例结节性硬化症患儿作为研究对象,分析诊断效果。结果:80例结节性硬化症平扫CT表现中,78例室管膜下钙化结节(钙化灶体积存在差异,边界清晰度高),其中71例患儿结节部位在侧脑室外侧壁,合并位于三脑室侧壁4例,位于四脑室侧壁3例;多发病灶、孤立钙化结节分别有72例、6例。41例皮质或皮质下结节,低密度灶,形状以斑片状为主;脑实质内斑片状钙化、脑室系统扩大(双侧侧脑室轻度扩大12例,侧脑室扩大明显或合并三脑室扩大5例)分别有20例、17例。3例CT增强扫描,远侧脑室侧壁结节强化。颅脑CT诊断中,钙化结节重叠呈烛泪征、脑皮质内片状低密度灶患儿分别有3例、1例;肺部CT诊断中,肺实质内可见多发小结节影患儿有4例、自发性气胸患儿2例;肾脏CT诊断中,肾脏外形增加4例、肿块合并出血患儿有2例;肝脏CT诊断中,肝脏系统内可见多发含脂肪密度肿块5例;胸椎CT诊断中,胸椎椎体及附件见多发斑点及斑块状硬化结节患儿有3例。结论:在对结节性硬化症患儿诊断时,平扫CT可发现颅内钙化结节或高密度结节,临床诊断价值高。Objective:To investigate the diagnostic efficacy of plain scan CT in pediatric tuberous sclerosis complex.Methods:80 pediatric patients with tuberous sclerosis complex treated at the Department of Radiology,Kaifeng Children's Hospital,from January 2019 to January 2022,were selected as study subjects to analyze the diagnostic efficacy.Results:Among the 80 tuberous sclerosis complex cases examined by plain scan CT,78 showed subependymal calcified nodules(with varying sizes of calcifications and high boundary clarity).Of these,71 nodules were located in the lateral walls of lateral ventricles,4 in the lateral walls of the third ventricle,and 3 in the lateral walls of the fourth ventricle.There were 72 multiple lesions and 6 isolated calcified nodules.Additionally,41 cases presented with cortical or subcortical nodules,manifested as low-density lesions predominantly in a patchy shape.20 cases exhibited patchy calcifications within the brain parenchyma,and 17 showed ventricular system enlargement(mild enlargement of bilateral lateral ventricles in 12 cases and significant enlargement of lateral ventricles or combined with enlargement of the third ventricle in 5 cases).Enhanced CT scans in 3 cases revealed nodular enhancement in the distal ventricular wall.In cranial CT diagnoses,3 cases exhibited overlapping calcified nodules resembling a candle-wax drip pattern,and 1 case showed patchy low-density lesions in the cerebral cortex.In lung CT diagnoses,4 cases had multiple nodules in the lung parenchyma,and 2 cases presented with spontaneous pneumothorax.Renal CT diagnoses revealed 4 cases with enlarged renal contours and 2 cases with masses accompanied by hemorrhage.In liver CT diagnoses,5 cases showed multiple fatty density masses within the hepatic system.Thoracic CT diagnoses identified 3 cases with multiple speckled and plaque-like sclerotic nodules in thoracic vertebral bodies and their annexes.Conclusion:Plain scan CT can detect intracranial calcified or high-density nodules in patients with tuberous sclerosis com

关 键 词：小儿 结节性硬化症 CT诊断 室管膜下钙化结节 皮质或皮质下结节 

分 类 号：R447[医药卫生—诊断学]