儿童外周性原始神经外胚叶肿瘤/Ewing’s肉瘤的声像图特征分析

Sonographic features of peripheral primitive neuroectodermal tumor/Ewing’s sarcoma in children

目的分析儿童外周性原始神经外胚叶肿瘤/Ewing’s肉瘤(pPNET/EWS)的声像图特点,探讨超声对其的诊断价值。方法选取41例pPNET/EWS患儿,总结分析其声像图特征,并与病理结果进行对照分析。结果41例pPNET/EWS患儿肿瘤发生于骨组织19例,软组织22例;均呈单发巨块状,超声测量肿瘤最大径(10.10±4.48)cm;肿块形态不规则,边界清晰;20例为不均质中等回声,18例为中等偏低回声,3例为不均质低回声;28例见混杂细点状“针尖样”,24例见簇状强回声,16例见条带状强回声,19例见混杂散在小片状无回声区呈“蜂窝状”,CDFI于其内可探及短条状血流信号,19例可伴骨皮质破坏。病理显示4例见大片坏死组织。结论pPNET/EWS的声像图特征具有一定特异性,超声可用于其诊断及随访,具有较好临床应用价值。

Objective To analyze the sonographic features of peripheral primitive neuroectodermal tumor/Ewing’s sarcoma(pPNET/EWS)in children,and to explore the ultrasonic diagnostic value.Methods The sonographic features of 41 children with pPNET/EWS were analyzed and compared with pathological results.Results Among the 41 cases of pPNET/EWS, there were 19 cases occurred in bone,and 22 cases occurred in the soft tissue.The ultrasonic image showed that the irregular shape,visible border,single and giant mass,the average value of the maximum diameter of the tumor measured by ultrasound was(10.10±4.48)cm. The tumor appeared as mostly medium(20 cases)or low echo(18 cases),3 cases were heterogeneous hypoechoic.The tumor might be mixed with“needlepoint-shaped”echo dots(28 cases),cluster(24 cases)or band-like strong echo(16 cases),also could be mixed with small region of scattered anechoic like“honeycomb”(19 cases),short strip blood flow signals coule be detected in tumor by CDFI. The tumor showed cortical destruction(19 cases).Pathological results showed large necrotic tissue(4 cases).Conclusion The sonographic features of pPNET/EWS has a certain specificity. Ultrasound can be used for the diagnosis and follow-up of pPNET/EWS,which has good clinical application value.