摘要
目的 总结儿童畸胎瘤样肾母细胞瘤的CT特点,提高对此病的认识.方法 对郑州大学附属儿童医院2017年-2022年经病理证实的7例儿童畸胎瘤样肾母细胞瘤的临床及CT资料进行回顾性分析,所有病例均行CT平扫及增强.结果 男5例,女2例,发病年龄6个月～71个月,中位年龄22个月,左肾4例,右肾3例,CT显示类圆形2例,分叶状4例,"8"字形1例,包膜完整4例,包膜不完整3例,最大径范围2.1～19.2 cm,瘤体均呈囊实性,瘤体内部见明确脂肪成分5例,未见明确脂肪成分但局部测得CT值为负值2例,瘤体内见钙化5例,未见钙化2例,增强扫描瘤体内实性部分不均匀强化,坏死囊变无强化,残存肾实质明显强化,呈新月征、抱球征.合并肾静脉瘤栓2例,同侧肾积水2例,肾门、腹膜后淋巴结肿大1例.结论 儿童畸胎瘤样肾母细胞瘤的CT表现具有一定特点,瘤体内可见明确脂肪成分或可测得脂肪密度,伴或不伴钙化,对术前诊断及鉴别诊断提供重要价值.
Abstract
Objective To summarize the CT features of teratomatoid wilms in children and improve the understanding of this disease.Methods The clinical and CT data of 7 cases of pathologically confirmed teratomatoid nephroblastoma in children's Hospital of Zhengzhou University from 2017 to 2022 were retrospectively analyzed.All cases were treated with plain CT scan and enhanced CT scan.Results There were 5 males and 2 females,aged from 6 months to 71 months,with a median age of 22 months.There were 4 cases of left kidney and 3 cases of right kidney,2 cases of circular,4 ca-ses of lobulated,1 case of"8"shape,4 cases of intact capsule and 3 cases of incomplete capsule,with a maximum di-ameter range of 2.1～19.2 cm.All tumors were cystic solid,and 5 cases of definite fat composition could be seen inside the tumor.No definite fat components were found but CT values were locally negative in 2 cases,calcification was found in 5 cases and no calcification in 2 cases.Enhanced scan showed uneven enhancement of solid parts in the tumor,nec-rosis cyst transformation was not enhanced,and the residual renal parenchyma was significantly strengthened,showing crescent signs and ball hugging signs.There were 2 cases with renal venous tumor thrombus,2 cases with ipsilateral hy-dronephrosis,and 1 case with hilar and retroperitoneal lymph node enlargement.Conclusion CT findings of teratoma-tous nephroblastoma in children have certain characteristics.Definite fat composition or fat density can be detected in the tumor,with or without calcification,which provides important value for preoperative diagnosis and differential diagnosis.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210668)
NETL
NSTL
万方数据