CT在儿童神经母细胞瘤诊断和随访中的价值

The Value of CT in Diagnosis and Follow-up of Pediatric Neuroblastoma

目的评价CT在儿童神经母细胞瘤诊断和随访中的价值。方法总结32例经病理证实、临床影像资料完整的神经母细胞瘤的临床CT表现。结果32例患儿中检出34个原发肿瘤,其中神经母细胞瘤33个,神经节神经母细胞瘤1个。肿瘤原发于肾上腺23例,腹部、盆腔交感神经链8例,纵隔1例;31个肿瘤可见钙化,腹膜后肿瘤跨越中线19例,肿瘤包埋血管12例,侵犯肾脏4例,腰大肌或髂腰肌受侵2例,侵入椎管2例,胰腺、膀胱受侵各1例;腹膜后淋巴结转移20例,纵隔淋巴结转移3例,骨转移8例,肝转移5例,肺转移1例;31例术前作出正确诊断,术前CT诊断正确率为96.9%;24例行1￣4次随访复查。结论CT对神经母细胞瘤诊断及随访有重要价值,可作为神经母细胞瘤诊断和随访的首选检查。

Objective To evaluate the value of CT in the diagnosis and follow-up of pediatric neuroblastoma. Methods Retrospectively analyze 32 patients with the whole clinic data and imaging. Results There were 34 neuroblastonma in 32 patients, including neuroblastoma 33 eases, Ganglia neuroblastoma 1 ease. Retroperitoneal tumor 31 patients,adrenal 23 eases, sympathetic nerve chain in celiac and pelvic8 eases. 1 ease localized mediastinum. Caleifieation were found in 31 patients. In the retroperitoneal masses, 19 exceeded median line, 12 encased blood vessels, 4 invaded kidney, 2 invaded psoas major muscle or iliopsoas muscle, 2 invaded vertebral canal, and 1 invaded pancreas and bladder respectively. There were 20 patients with metastasis in retroperitoneal lymph nodes, 3 eases with mediastinal lymph nodes, 8 eases with bone metastasis and 5 liver metastasis. The accurate diagnosis was got in 31 patients before operation. The accurate diagnosis rate of CT in this group was 9619%. 24 patients were followed up 1 to 4 times by CT. Conclusion CT was very important for diagnosis and follow-up, CT was the first selection in the diagnosis and follow-up of neuroblastoma.