85例小儿肾母细胞瘤的螺旋CT诊断

The Value of CT Diagnosis for Nephroblastoma in Children

目的探讨螺旋CT对小儿肾母细胞瘤的诊断价值,以便于指导临床治疗。方法分析85例经手术、病理证实为肾母细胞瘤的CT表现。结果肾母细胞瘤单侧多见,双侧少见。多发于肾脏上极,也可全部,常表现为强化不明显的实性肿块,瘤内常有坏死、囊变、出血,少数有钙化,典型CT表现为残存肾实质呈新月形强化。本组术前定性诊断准确率为93%。结论螺旋CT检查能准确显示肾母细胞瘤的大小、形态、密度、侵犯的范围及转移情况,很好地评价对侧肾脏的情况,对肿瘤分期、指导临床制定治疗方案及估计预后有重要的意义。

Objective To evaluate the value of diagnosticing of CT scan for nephroblastoma in children. Methods Eighty-five patients with pathologically confirmed nephroblastoma were analysed retrospectively for their CT scans with and without contrast enhancement. Results The tumor seemed to likely envolve the unilateral kidney, but bilateral lesion was also observed. Polar envolvement of the kidney was seen in most of the cases though whole kidney envolvement was also the case. The tumour appeared usually a poorly enhanced solid mass,in which necrosis and cystic change were often found,while seldom the tumour presented with hemorrhage and calcifications. A characteristic CT finding was that the residual kidney presented the enhancement in the crescent or ring like pattern. In some patients,the normal structure of kidney could not be found. All the lesions were found on CT image before surgical resection. Preoprative diagnostic accuracy was 93%. Conclusion Small lesion of nephroblastoma can be demonstrated by CT scan with contrast-enhancement. The evaluation of the function of the contralateral kidney and information of the evolvement and metastasis of the lesion can be obtained by CT scan with contrast-enhancement, which are essential to the staging and treatment planning.