小儿肾母细胞瘤的CT表现特点及诊断分析

CT Features and Diagnosis of Nephroblastoma in Children

目的分析小儿肾母细胞瘤的CT表现特点及诊断价值。方法回顾性分析我院2014年2月至2017年2月经病理证实为肾母细胞瘤的小儿患者68例,所有病例均行CT平行扫加增强扫描,分析小儿肾母细胞瘤的CT表现特点,并分析CT征象与手术病理特征关系。结果患儿病灶大小为74mm×73mm×98mm-146mm×142mm×117mm,分布主要以单侧多见,多发于上极,病灶多为圆形或类圆形;平扫显示密度不均匀肿块,在行增强扫描后病灶部位呈现轻度至中度的不均匀延迟强化,残存的受推压的肾实质呈"新月形"或"环形"强化;CT诊断邻近组织结构侵犯准确率为90.91%,CT诊断有淋巴结转移准确度为87.50%。结论肾母细胞瘤多发于5岁以下儿童,经CT诊断能准确的显示出肾母细胞瘤的大小、形态、分布、密度以及侵犯与转移情况,CT表现具有一定的特征性,对肿瘤分期、临床治疗方案的制定以及预后判断有着重要意义。

Objective To analyze the CT features and diagnostic value of nephroblastoma in children.Methods A total of 68 children with pathologically confirmed nephroblastoma who were admitted to our hospital between February 2014 and February 2016 were retrospectively analyzed. All cases underwent CT plain scan and enhanced scan. The CT features of nephroblastoma in children were analyzed, and the relationship between the CT features and surgical and pathological characteristics was analyzed, Results The average size of lesions in children was 4mm×73mm ×98mm-146mm × 142mm × 117mm. The lesions were mainly distributed on one side and mostly occur in the upper pole. The lesions are mostly round or circular. Plain scan showed masses with uneven density. After the enhanced scan, the lesions showed mild to moderate uneven and delayed enhancement, and the residual pressed renal parenchyma showed crescent or annular enhancement, The accuracy of CT in the diagnosis of adjacent tissue invasion was 90.91%, and in the diagnosis of lymph node metastasis was 87.50%.Conclusion Nephroblastoma is more conmlon in children under 5 years old. CT can accurately show the rumor size, shape, distribution, density, invasion and metastasis of nephroblastoma. The findings of CT are characteristic, which is of great importance to tumor staging,development of treatment plan and prediction of prognosis.