儿童后肾腺瘤的MSCT影像表现

MSCT Imaging Findings of Metanephric Adenoma in Children

目的 探讨儿童后肾腺瘤(metanephric adenoma,MA)的MSCT影像表现,提高对儿童MA的认识与诊断水平。方法 回顾6例经手术病理证实的MA患儿临床、影像与病理资料,归纳肿瘤特点与CT表现。结果 6例MA,女5例,男1例,中位年龄3岁,实验室示红细胞增高3例。左肾4例,右肾2例,均单肾单发,外生突出肾轮廓5例,形态规则5例(类圆形3例,卵圆形2例),不规则分叶1例,最大直径2.7~8.1cm,实性3例,囊实性3例,平扫肿瘤实性成分密度均高于肾实质,CT值43~56HU,囊性成分CT值12~19HU,1例伴斑点状钙化,增强扫描肿瘤皮质期CT值52~67HU,实质期CT值79~97HU,排泄期CT值89~119HU,增强各期肿瘤强化程度低于肾实质,与周围组织分界清晰,2例继发轻度肾积水,均未见转移复发。结论 儿童MA的MSCT影像表现具有一定特点,合并红细胞增多症,可提示该病,最终确诊需病理支持。

Objective To explore the MSCT imaging manifestations of metanephric adenoma(MA) in children,and improve the understanding and diagnosis of children’s MA. Methods The clinical,imaging and pathological data of 6 children with MA confirmed by surgery and pathology were reviewed,and the tumor characteristics and CT manifestations were summarized. Results There were 6 cases of MA,5 cases of female and 1 case of male,with a median age of 3 years. The laboratory showed an increase in red blood cells in 3 cases. There were 4 cases of left kidney and 2 cases of right kidney,all of which were single kidney,5 cases of exogenous protruding kidney outline,5 cases of regular shape(3 cases of round shape,2 cases of oval shape),1 case of irregular lobes,the largest Diameter 2.7~8.1cm,3 cases were solid,3 cases were cystic-solid,the density of solid component of plain scan tumor was higher than that of renal parenchyma,CT value was 43~56HU,CT value of cystic component was 12~19HU,1 case had spot shape Calcification,enhanced scan tumor cortical phase CT value 52~67HU,parenchymal CT value 79~97HU,excretion phase CT value 89~119HU,the enhancement degree of each stage tumor is lower than the renal parenchyma,and the boundary with surrounding tissues is clear,secondary to 2 cases There was no metastasis or recurrence in mild hydronephrosis. Conclusion The MSCT imaging manifestations of children’s MA have certain characteristics,combined with polycythemia,which may indicate the disease,and the final diagnosis requires pathological support.