25例儿童肾母细胞瘤的CT诊断分析

CT diagnosis of nephroblastoma in 25 pediatric patients

目的:探讨儿童肾母细胞瘤的CT诊断价值。方法:回顾经手术和病理证实的肾母细胞瘤25例CT影像资料,男14例,女11例,年龄4月～10岁,平均3.2岁。其中3例只作CT平扫,22例作平扫加增强。结果:发生于左肾者14例,右肾9例,先后发生于双肾者1例,发生于肾外者1例。绝大部分病例未受累的残存肾脏实质受压呈新月形,残存肾盂肾盏均出现不同程度扩张积水。所有病灶在增强扫描时均呈轻中度不均匀强化。25例共26个病灶边界基本清楚者24个,边界大部分不清楚者2个。出现肾静脉和下腔静脉癌栓2例,输尿管瘤栓1例,出现肝和/或肺等远处转移3例。结论:儿童肾母细胞瘤在CT检查中有特征性表现,CT平扫加增强对其定位定性诊断具有重要价值。

Objective：To determine the CT diagnosis value in the nephroblastoma（Wilms tumor）of 25 pediatric patients.Methods：CT images of 25 pediatric patients with nephroblastoma which have been confirmed by surgical operation and biopsy pathology were reviewed retrospectively,14 male,11 female,age range：4 months-10 years,mean 3.2 years.3 cases had plain CT scans,22 cases had enhanced CT scans.Results：23 cases originated from the kidney with the right 14 and the left 9,1 case originated from bilateral kidneys in succession,and 1 case originated from the extrarenal retroperitoneum in the vast majority cases.The appearances of the the remnants renal parenchyma noninvolved are crescentiform with hydronephrosis,larger than 4.5 cm in size,only ten cases encroach to the renal capsule.The tumour appeared usually a slight and heterogeneous enhancement.24 cases（of total 26 foci）were well defined and 2 cases were ill defined,2 cases had cancer embolus in the renal vein and inferior cava vein,1 case had ureter involved,3 cases found the metastasis in the liver andor lung.Conclusion：Pediatric nephroblastoma is characteristic in the CT examination.CT has significant value of qualitative and positioning diagnosis in the nephroblastoma.