小儿肾母细胞瘤的CT诊断与鉴别诊断

CT diagnosis and differential diagnosis of Wilmstumors for children

目的探讨CT在小儿肾母细胞瘤的诊断及鉴别诊断中的作用。方法回顾性分析经临床、手术及病理证实的小儿肾母细胞瘤20例,所有病例均行CT平扫加增强扫描。结果肾母细胞瘤发生于左肾9例,右肾9例,双肾2例,22个病灶表现为实质性肿块20个,囊实性肿块2个,未见完全囊性肿块。出现坏死液化20例,斑点状、条状钙化3例,片状出血2例。肿块直径5～16cm,15个病例直径>10cm。肿块呈类圆形15例,分叶状5例,包膜完整或大部分完整18例,包膜不清2例。结论儿童肾母细胞瘤CT表现具有一定特征性,对定性诊断、鉴别诊断、病变分期以及临床治疗有重要参考价值。

Objective To investigate the importance of CT diagnosis and differential diagnosis in Wilms＇tumors for children.Methods 20 cases of Wilms＇tumors confirmed by clinic,surgery and pathology were retrospectively analyzed and all cases had plain and enhanced CT scans.Results 9 cases had tumor situated in the left kidney and 9 cases in the right. Among the 20 cases,there were 22 tumors appeared in solid masses and 2 in cysticsolid masses. There was no cystic masses. 20 cases displayed putrescence and fluidification.3 cases displayed small spotted or cambered clouded calcification,2 cases displayed clouded hemorrhage. The diameters were from 5 cm to 16 cm,in 15 cases the tumor diameter was above 10 cm. 15 cases displayed sublobe shape tumors,5 cases displayed sublobe shape tumors,18 cases showed rounded or half-baked envelope and the tumors＇ envelope was unclear in 2 cases.Conclusion Pediatric nephroblastoma showed some characteristics in the CT examination. CT had significant value in characterizing diagnosis,differential diagnosis,Staging and clinical treatment.