小儿卵巢肿瘤的CT诊断价值

Value of CT in the diagnosis of ovarian neoplasm in children

目的：利用多层螺旋CT分析小儿卵巢肿瘤的影像特点。方法：经手术病理确诊的27例女性患儿共34个卵巢肿瘤病例资料,年龄1.1-18.0岁,平均（11.7±5.1）岁;使用Philips Brilliance 6层螺旋CT进行平扫和增强扫描;1例肿瘤扭转的急腹症患儿仅行平扫。结果：CT表现为单纯囊性肿瘤11个（11/34,占32.35%）,实性肿瘤有9个（9/34,占26.47%）,囊实性肿块14个（14/34,占41.18%）。增强扫描后有29个卵巢肿瘤可见卵巢血管蒂征,占87.88%。12例可见腹水,4例有腹膜种植。9例淋巴结肿大,5例出现肝肺等远处转移。钙化15个,13个畸胎瘤均见钙化,同时可见钙化及脂肪成分者11个,2个畸胎瘤未见确切脂肪成分。结论：CT扫描易于显示肿瘤囊实性、钙化及脂肪成分以及卵巢静脉的走行等征象,对于小儿卵巢肿瘤的定位、定性及协助分期等有重要价值。

Objective：To analyze the multi-slice spiral CT（MSCT） characteristics of ovarian neoplasm in children.Methods：27 female pediatric patients with 34 surgery and pathology proven ovarian neoplasms were included in this study,with the age 11.7± 5.1（ranged from 1.1 to 18.0 years）.The studies were performed by a multi-slice spiral CT scanner with pre-and post-enhanced scanning.The initial symptoms of 1 case was acute abdomen with tumor torsion,only non-enchanced CT was performed.Results：Of the CT findings,there were simple cystic tumor（n=11,11/34,32.35%）;solid mass（n=9,9/34,26.47%）;mixed cystic and solid mass（n=14,14/34,41.18%）.Ovarian vascular pedicle sign（OVPS） was revealed in 29 ovarian neoplasms after contrast enhancement,account for 87.88%.There were ascites（12 cases）,peritoneal implantation（4 cases）,lymphadenopathy（9 cases）,distant metastasis of liver or lung（5 cases）.Calcification was seen in 15 tumors.All of the 13 ovarian teratomas had intra-tumoral calcification,both calcification and fatty components were seen in 11 tumors.No obvious fatty composition could be assessed in 2 teratomas.Conclusion：CT imaging can easily display the cystic,solid,calcification,and adipose tissue components as well as the pathway of ovarian veins within the tumor,which plays an important role in defining the location,nature and staging of ovarian neoplasm in children.