儿童卵巢卵黄囊瘤的临床表现、超声及CT对照分析

Comparative analysis of clinical manifestation,ultrasound and CT of yolk sac tumor of ovary in children

目的:通过对儿童卵巢卵黄囊瘤的临床表现、超声及CT特征分析,提高对儿童该病的认识和诊断率。方法:收集我院2014—2021年经病理确诊的13例儿童卵巢卵黄囊瘤患者资料,通过对该13例患儿卵巢卵黄囊瘤的二维超声特点、彩色多普勒及能量多普勒血流半定量分级、CT平扫及增强扫描并结合临床表现和实验室检查结果综合回顾分析。结果:13例患儿年龄最大的14岁,最小的1岁,5例(38%)以腹痛就诊,7例(54%)以腹部肿块就诊,1例(8%)以尿频就诊。超声提示13例患儿的肿块均位于盆腔或下腹部,9例(69%)病灶以实性为主的实性病变,4例(31%)病灶以囊性为主的囊实性病变,Adler血流分级均在Ⅱ~Ⅲ级。CT平扫显示为下腹部或盆腔圆形或类圆形等、低密度的囊实性肿块,CT增强扫描显示为盆、腹腔渐进性不均匀增强的囊实性肿块,部分可见点状或线状血管影。13例患儿甲胎蛋白升高,均>1 210 ng/mL。结论:儿童卵巢卵黄囊瘤常见的临床表现为腹痛和腹部肿块,当超声或CT检查发现女童盆腔或下腹部囊实性占位并伴随甲胎蛋白升高时可优先考虑为卵巢卵黄囊瘤。

Objective:To improve the recognition and diagnostic rate of ovarian yolk sac tumor in children by analyzing its clinical manifestations,ultrasonic and CT features.Methods:The data of 13 children with ovarian yolk sac tumor diag-nosed by pathology in our hospital from 2014 to 2021 were collected,and the two-dimensional ultrasound characteristics,color Doppler and power Doppler blood tests of the 13 children with ovarian yolk sac tumor were collected.Flow semi-quantitative grading,CT plain and enhanced scans,combined with clinical manifestations and laboratory test results,were comprehensively retrospectively analyzed.Results:The oldest of the 13 cases was 14 years old and the youngest was 1 year old.Five cases were treated with abdominal pain(38%),7 cases with abdominal mass(54%),and 1 case with frequent urination(8%).Ultra-sound showed that the masses of 13 children were located in the pelvis or lower abdomen,9 cases were solid lesions(69%),4 cases were cystic lesions(31%),and Adler blood flow grade wasⅡ~Ⅲ.Plain CT scan showed round or quasi round low-den-sity cystic and solid masses in the lower abdomen or pelvic cavity,while enhanced CT scan showed progressive and uneven enhancement of cystic and solid masses in the pelvic and abdominal cavity,with dotted or linear vascular shadows in some parts.The level of alpha fetoprotein in 13 children was higher than 1210 ng/mL.Conclusion:The common clinical manifesta-tions of ovarian yolk sac tumor in children are abdominal pain and abdominal mass.When ultrasound or CT examination finds cystic and solid masses in the pelvic cavity or lower abdomen of girls with elevated alpha fetoprotein,it can be considered as ovarian yolk sac tumor first.