小儿肝母细胞瘤的CT表现及临床应用价值

CT findings and its clinical application in hepatoblastoma of children

目的：探讨肝母细胞瘤的临床及CT表现,以提高其诊断准确率。方法：回顾性分析经手术及病理证实的肝母细胞瘤13例,结合文献回顾性分析肝母细胞瘤的临床和CT表现。结果：肿瘤主体位于肝右叶10例,肝左叶2例,跨左右叶1例。肿块最大径约11~24cm,平均16cm。8例轮廓光滑,边界清楚,包膜较完整,5例部分边界不清。CT平扫肿瘤呈低、等混杂密度肿块,肿瘤内见裂隙状或不规则更低密度区,7例可见瘤内小斑点状或弧形钙化;增强扫描动脉期13例肿瘤呈不均匀性强化,分隔及周边的结节明显强化,但强化程度低于正常肝组织。坏死或液化区均无明显强化。门脉期8例瘤内分隔延迟强化。3例侵犯门脉血管。结论：CT能较好的描述肿瘤的范围、包膜的完整性,对肝内血管和下腔静脉的侵犯情况提供了较多的信息,对临床治疗方案的制定和预后起重要的作用。CT上肝母细胞瘤有一定的特征性,结合患者年龄、AFP可提供诊断的准确率。

Objective： To study the clinical features and CT appearances of hepatoblastoma（HB ）. Methods： The CT findings and clinical data of the 13 pathology and surgery cenfirmed HB were retrospectively analyzed. Results： Ten tumors involved the right lobe, two involved the left lobe, and 1 involved beth liver lobes. The diameter was 16 em in average. In CT plain scan most of HB showed a slit- shaped or irregularly low density area in hypo-or isodensity solid mass. Seven eases showed mottling or curviliear calcification. Tumor showed moderate inhomogeneous and heterogenie enhanced. Eight intratumoral septal were delayed enhancement. Three showed portal vein infiltration. Conclusion： CT scan delineate the extent of HB, provide information of the liver vessels and inferior vena eava. CT was helpful in the diagnosis, monitoring and follow-up in HB patients. HB have some characteristic CT manifestations. Combination with the age and AFP can elevate the diagnosis accuracy.