小儿横纹肌肉瘤的CT诊断

CT features of rhabdomyosarcoma in children

目的:探讨小儿横纹肌肉瘤的CT特征。方法:对17例经手术病理证实的横纹肌肉瘤的起源、大小、组织学类型和CT表现进行回顾性分析。所有病例均行平扫加增强扫描。结果:横纹肌肉瘤位于头颈部2例,均表现为境界清楚的软组织肿块,密度均匀,平扫低于肌肉组织,强化幅度高于肌肉组织但低于血管,邻近骨质未见溶骨性破坏;四肢躯干6例,轻到中度强化,均匀强化2例,"斑马纹状"强化3例,邻近骨质破坏不明显;腹盆腔4例,3例表现为不均匀强化的等或稍低密度较大肿块,内见坏死,邻近组织受侵犯,其中1例可见小条形钙化、2例邻近骨质破坏、1例位于肠系膜者密度均匀并呈不均匀条形强化;泌尿生殖系5例,其中1例表现为多个结节状软组织肿块、1例表现为膀胱内肿块。结论:小儿横纹肌肉瘤发生部位、年龄不同,有着一定的CT特征表现,这有助其早期明确诊断。

Objective： To investigate CT features of the pediatric rhabdomyosarcoma. Methods： Position, size, histological type and CT findings of rhabdomyosarcomas were retrospectively analyzed in 17 patients. All cases were confirmed by post-operative pathology. Results： Two cases located in the head and neck, including the left neck and tongue root, which showed clear borders and uniform density and significant enhancement and non-destruction of adjacent bones in CT scans. Six cases located in the limbs and trunk, which revealed clear edges and homogeneous density, but also demonstrated mild or moderate or zebra-patternoid enhancement and non-destruction of adjacent bones. 4 cases located in the abdomen, include 3 cases in the retroperitoneal and one case containing calcification and 3 cases appearing low-density necrosis and one case representing bone destruction. In addition, 5 cases located in genitourinary, one case displayed multiple nodules among them. Conclusion： With the different occurrence site and ages, CT findings of pediatric rhabdomyosarcomas possess some characteristic performance and it may be helpful to improve capability of early diagnosis and treatment.