小儿肾母细胞瘤的CT诊断价值

Diagnosis value of CT on nephroblastoma in children

目的探讨CT在小儿肾母细胞瘤诊断中的价值。方法收集我院经手术、病理证实的32例肾母细胞瘤的临床及影像学资料，进行回顾性分析。其中男17例，女15例，全部病例均行CT平扫和增强扫描。结果肾母细胞瘤单侧多见，双侧少见。起源于肾脏一侧，上极多于下极，常表现为不明显的强化实质性肿瘤伴坏死与出血。压迫后残存肾实质呈“新月型”强化。结论肿瘤与残肾交界面的“锯齿”、“蟹足”或“怀抱”征以及残余肾的“新月形”强化是肾母细胞瘤CT最具有特征性的表现，借此可与肾周围非肾源性肿瘤相鉴别，非常有助于肾母细胞瘤的诊断与鉴别诊断。

Objective To evaluate the diagnostic value of computed tomography on nephroblastoma in children. Methods Clinical and imaging datas of thirty - two cases of nephroblastoma, who had been proven surgically and pathlogieally, were retrospectively analysed. All the patients （17 male, 15 female） received plain scans and enhancement with intravenous contrast medium. 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 can also be seen. The tumour appeared usually a poorly enhanced solid mass, in which necrosis and hemorrhage were often found. A characteristic CT finding was that the residual kidney presented the enhancement in the crescent or ring like pattern. Conclusions The ＂serrature＂, ＂beak sign＂, ＂embedded kidney sign＂ and ＂crescent sign＂ are the most specific CT signs suggestive of nephroblastoma and distinguish them from non - renal origin tumors within the perirenal space, which are very important to the diagnosis and differential diagnosis of nephroblastoma.