儿童肾母细胞瘤的CT诊断价值

The value of CT diagnosis for nephroblastoma in children

目的 :探讨CT对肾母细胞瘤的诊断价值 ,指导临床治疗。资料与方法 :回顾性分析 43例病理证实为肾母细胞瘤平扫加增强扫描的CT征象。结果 :肿瘤单侧多见 ,也可为双侧 ,多发生于肾脏一极 ,也可全部 ,常表现为强化不明显的实性肿块 ,瘤内常有坏死、囊变 ,少数有出血、钙化 ,典型表现为残存肾实质变薄 ,呈新月形、环形 ,或肾的正常结构消失。本组术前发现病灶 10 0 % ,诊断准确率 95 %。结论 :CT增强扫描能发现小病灶的肾母细胞瘤 ,很好地评价对侧肾脏的情况 ,并能明确肿瘤的范围以及转移的情况 ,对肿瘤的分期、指导临床制定治疗方案有重要的意义。

Objective:TO evaluate diagnostic Value of CT scan for nephroblastoma in children Methods:Forty three patients with pathologically confirmed nephrblastoma were analizd retrospectively for their CT scans with and without contrast enhancement 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 was also the case The tumour appeared usually a poorly enhanced solid mass, in which necrosis and cystic change were often found, while seldom the tumour presented with hemorrhage and calcifications A characteristic CT finding was that the residual kidney presented the enhancement in the crescent or ring like pattern In some patients, the normal structure of kidney could not be found All the lesions were found on CT image before surgical resection Preoprative diagnostic accuracy was 95% Couclusion:Small lesion of nephroblastoma can be demonstrated by CT scan with contrast enhancement The evaluation of the function of the contralateral kidney and information of the evolvement and metastasis of the lesion can be obtained by CT scan with contrast enhancement, which are essential to the staging and treatment planning