儿童肾透明细胞肉瘤MDCT影像表现

MDCT features of clear cell sarcoma of the kidney in children

目的探讨儿童肾透明细胞肉瘤(CCSK)的多层螺旋CT(MDCT)影像学特点。方法回顾性分析2013年10月~2017年6月,经病理证实的8例CCSK的MDCT影像资料,结合文献复习进行分析。本组男5例,女3例,年龄4个月~8岁,中位年龄3岁10个月。8例患儿均行MDCT平扫及双期增强扫描检查。结果 8例患儿肿瘤均呈膨胀性生长,直径约为4.7~13.8 cm,中位直径12.1 cm,均为单侧肾脏发病,增强见不同程度囊变坏死,呈囊实性成分相间排列,其中5例出现大片囊变,实性成分血供较丰富,强化程度达28~56 HU,2例见斑点状钙化,2例初诊即发现骨转移,2例见下腔静脉及腹主动脉受压移位。结论儿童CCSK的MDCT影像学表现具有一定特点,结合早期出现骨转移的特点有助于诊断。

Objective To evaluate the multi-detector computed tomography（MDCT） features of pediatric clear cell sarcoma of kidney（CCSK）. Methods The MDCT imaging features in 8 children with pathologically confirmed CCSK from October 2013 to June 2017 were reviewed. All patients（5 boys, 3 girls; age range： 4 months-8 years; median： 3 years and 10 months） underwent unenhanced and contrast-enhanced MDCT in the cortical and parenchymal phases. Results The tumor was expansile with well-defined border and median diameter of 12. 1 cm（range： 4.7-13.8 cm）. All tumors were confined to single kidney with various degrees of cystic and necrotic changes. The solid components demonstrated relative hypervascularity with CT densities of 28-56 HU after contrast enhancement. Other findings included calcifications（2）, bone metastases（2）, inferior vena cava and abdominal ao rta displacement（2）. Conclusion Pediatric CCSK presents with relatively specific MDCT features, which may have potential diagnostic value in combination with bone metastases.