小儿横纹肌肉瘤的CT诊断

The CT diagnosis of rhabdomyosarcoma in children

目的探讨小儿横纹肌肉瘤（RMS）的CT表现。方法回顾性分析24例经病理证实的小儿RMS的CT资料。结果头颈部RMS3例，CT表现为境界清楚的软组织肿块，密度均匀，增强后强化明显，邻近骨质无破坏。四肢躯干RMS8例，CT表现为境界清楚，密度均匀的软组织肿块，增强后轻至中度均匀或不均匀强化，相邻骨质破坏不明显。腹盆腔RMS6例，5例CT表现为等或稍低密度较大肿块，密度不均，增强后呈不均匀强化，腹膜后未见淋巴结转移；另1例位于肠系膜，CT表现为低密度肿块，密度均匀，增强后不均匀条纹状强化。泌尿生殖系统RMS7例，其中位于膀胱2例，CT表现为膀胱壁不均匀增厚伴突向膀胱腔内的肿块，平扫呈略低密度，增强后明显强化，边界不清；位于后尿道1例，CT表现为盆腔内囊实性包块，浅分叶，增强后囊性部分未见强化，实性部分明显强化；位于阴道、阴囊、睾丸、会阴部各1例，CT表现为结节状较低密度肿块，密度均匀，增强后轻度至中度均匀强化。结论小儿RMS随部位和年龄不同有一定的CT特征表现，对早期正确诊断有重要的价值。

Objective To study the performance of children rhabdomyosarcoma （RMS） in CT examation. Methods Twenty-four cases clinical and CT data of RMS which were confirmed by pathology were analyzed retrospectively. Results In head and neck RMS （3 cases）, the performance were well-circumscribed soft tissue with uniformity density which were obviously improved after enhancement and showed no invasion to the adjacent bone. In trunk limbs RMS （8 cases）, the performance were well-circumscribed soft tissue of many different sizes with uniformity density and mild to moderate uniform（or non-uniform） enhancemen,and the invasion to the adjacent bone was not obvious. In peritoneum and retroperitoneum RMS （6 cases）, 5 cases showed non-uniformity isodensity or slightly low density with non-uniformly enhancement and without retroperitoneal lymph node metastasis. The mesenteric （1 case） showed low uniformity density mass and non-uniformly bar enhancement. In urogenital system RMS （7 cases）, 2 cases located in the bladder, and 4 cases respectively located in the vagina, scrotum, testicles and perineum. The performances were uniformity density soft tissue mass like nodular with moderate uniform enhancement. One case located in posterior urethral, whose performance was cystic and solid mass. The cystic part had no enhancement, and the solid part had obviously uniform enhancement. Conclusion The characteristic performance about children RMS is different along with the different parts and age in CT, which has important value for early diagnosis.