儿童腹膜后副神经节瘤CT影像学特点分析

The application of CT in the diagnosis of retroperitoneal paraganglioma in children

目的：分析儿童腹膜后副神经节瘤的CT影像学特点,结合其病理特征,提高临床医生对本病的诊治水平。方法：对病理诊断为腹膜后副神经节瘤的4例（男2例,女2例）患儿的CT资料进行回顾性分析,其中1例行CT平扫＋增强＋三维扫描,其他3例行平扫＋增强扫描。结果：CT平扫显示腹膜后软组织密度影,肿瘤实体CT值为26-40 HU,密度不均,肿物直径4-9.5 cm。CT增强扫描显示肿物呈不均匀强化,内部可见星芒状无强化液性坏死区,其内及周边均有多发血管影,1例三维重建提示周边可见囊性变肿块与邻近血管结构分界不清。结论：儿童腹膜后副神经节瘤为少见肿瘤,CT检查可以清楚显示腹膜后副神经节瘤的大小、边界、密度、血运及肿瘤内物质组成。血运异常丰富的腹膜后肿瘤应高度怀疑副神经节瘤,并结合临床表现、病理组织检查对病变做出较准确的诊断及治疗。

Objective： To analyze the CT imaging characteristics of children with retroperitoneal paraganglioma, combined with its pathological features, and to improve the level of diagnosis and treatment of the disease. Methods： The CT data of 4 cases（male 2, female 2） of retroperitoneal paraganglioma confirmed by pathology were analyzed retrospectively, including 1 case for CT scan＋3D, the other 3 cases for scan＋enhancement. Results： CT scan showed that the retroperitoneal lesions were the soft tissue density, the CT values of the tumors were 26-40 HU, the density was uneven, and the tumor diameters were 4-9.5 cm. Enhanced CT demonstrated that tumors were heterogeneous enhanced, the internal liquid necrotic areas showed no enhance- ment, multiple blood vessels were in and around tumors. Three dimensional reconstruction of 1 case exhibited that the boundary between cystic mass and adjacent vascular structure was not clear. Conclusion： Retroperitoneal paraganglioma is a rare tumor in children. CT scan can clearly show the size, boundary, density, blood flow, and the substance composition of retroperitoneal paraganglioma, and combined with the clinical manifestations and pathological examination can make more accurate diagnosis and treatment of the disease.