儿童肾母细胞瘤的CT 诊断(1)
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[摘要]目的 分析CT对于儿童肾母细胞瘤的诊断价值。方法 回顾性分析31例经手术病理证实的肾母细胞瘤的CT表现。结果 31例均为单侧发病，肿瘤较大，20例均为实性(64.5 %)，囊实混合性11例(35.5 %)，8例可见钙化，除1例未见明显强化外，其余均可见不均匀强化。残存受压的肾实质在增强CT扫描上呈新月形改变。肿瘤可侵犯肾包膜，腹膜后、膈脚后淋巴结转移常见。结论 CT检查能发现肿瘤的部位、浸润范围、分期、是否有淋巴结转移及血管受侵等情况，有助于手术方案的选择及预后。
[关键词] 肾母细胞瘤；儿童；体层摄影术；X线计算机
[中图分类号] R441.5；R737.11 [文献标识码] B [文章编号] 1673-9701(2011)32-102-02
CT Diagnosis of Neuroblastoma in Children
HE Liu1 GAO Yuying2
1.Department of Radiology, Affilicated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China；2.Department of Radiology, Affilicated Shengjing Hospital of China Medical University, Shenyang 110004, China
[Abstract] Objective To Analysis the CT evaluation in the diagnosis of nephroblastomatosis in children. Methods Thirty-ong cases of nephroblastomatosis confirmed by clinic and pathology were retrospectively analyzed，CT characteristics of nephroblastomatosis were discussed. Results All cases occured unilaterally and were big generally, which appeared in solid masses in 20 cases (64.5%),cysticsolid masses in 11 cases(35.5%). And, calcification was seen in 8 cases. All cases were performed contrast-enhanced CT. All cases except 1 case which exhibited no contrast-enhance were mixed contrast-enhanced. The remaining contrast-enhanced renal parenchyma exhibited a “new-moon shape” enhancement. Tumor often invaded renal capsule，and metastasis was seen first in the lymph node of retroperitoneum and posterior to diaphragmatic crus .Conclusion CT can detect location of mass and invasion, staging and metastasis, and provide important evidence for the operation and prognosis.
[Key words] Neuroblastoma; Children; Tomography; X-ray computed
肾母细胞瘤是儿童常见的发生于肾脏的恶性肿瘤，又名Wilms瘤。肿瘤治疗前的方案选择主要依赖于CT检查。本文搜集31例肾母细胞瘤进行回顾性分析，探讨CT对于本病的诊断价值。
1 资料与方法
31例肾母细胞瘤全部经手术病理证实，其中 男14例，女17例，年龄1个月～14岁(平均3.4岁)，临床表现为腹部肿块 21例 ，血尿 2例 ，发热 3例 ，腹痛 5例 。CT扫描机为Siemens Sensation64及Brilliance40，增强扫描造影剂为欧乃派克80mL(2.5 mL /s)，扫描范围为肝门至双肾下极，层厚为3mm。
2 结果
①部位：发生于左肾者17例，右肾14例，上极14例，中下极5例，下极10例，大部分肾2例。②大小：肿瘤最小为4cm×5cm，最大为12.8cm×12cm。直径<5cm者2例，5～10cm者20例，其余9例>10cm ......
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