成人腹部神经母细胞瘤多层螺旋CT表现与分析

CT features of abdominal neuroblastoma in adults

目的探讨成人腹部神经母细胞瘤(NB)的多层螺旋CT(MSCT)表现并总结其影像特征。方法回顾性分析经手术病理证实的9例成人腹部NB病例,均有完整术前影像资料,男4例,女5例,年龄18~67岁,中位年龄28岁。9例中8例行MSCT平扫加增强检查,1例仅行MSCT平扫检查;其中4例行PET-CT检查。结合临床特点分析和总结其MSCT特征。结果腹膜后8例包括(肾上腺区6例、腹膜后-盆壁和腹膜后主动脉旁各1例),盆腔1例,均位于交感神经链分布区。9例病灶形态均不规则,8例呈分叶状改变,最大径线41~140 mm。9例平扫均呈不均匀等低密度,增强扫描8例呈不均匀强化(3例明显强化,5例轻中度强化)。5例出现少许斑点、片状钙化。4例多发淋巴结转移,其中1例合并远处转移。结论成人腹部NB有一定的临床及影像特征,年轻成人交感神经链分布区的不规则等低密度肿物并钙化,需考虑成人NB。

Objective To investigate the imaging features of adult abdominal neuroblastoma on multi-slice spiral CT(MSCT).Methods Nine patients(4 men,5 women;age range:18-67 years,mean age:28 years)with pathologically confirmed abdominal neuroblastoma underwent nonenhanced(9)and enhanced(8)MSCT and PET-CT(4)examination.The MSCT features were analyzed and summarized.Results All tumors were located in the sympathetic nerve chain distribution area with 8 involving the retroperitoneum including the adrenal glands(6),between the retroperitoneum and the pelvic wall(1),and para-aortic retroperitoneum(1)and 1 tumor in the pelvic cavity.All tumors were irregular in shape with lobulation(8)and the maximum diameter ranging from 41 to 140 mm.All lesions were iso-or hypodense on nonenhanced CT with patchy calcification(5),heterogeneous marked(3)or mild to moderate(5)contrast enhancement.Multiple lymph node metastases were found in 4 including 1 patient with distant metastasis.Conclusion Adult neuroblastoma should be considered if CT shows irregular low-density mass with calcification in the area of sympathetic nerve chain distribution in young adults.