摘要
目的 分析不同病理类型儿童肝母细胞瘤的超声表现.方法 回顾性分析我院收治的36例肝母细胞瘤患儿的超声及病理资料,总结不同病理类型(完全上皮细胞型、不伴畸胎样混合型、伴畸胎样混合型)儿童肝母细胞瘤的超声表现.结果 36例肝母细胞瘤中,完全上皮细胞型13例,其中肿瘤位于肝右叶7例,左右叶3例,左叶2例,尾状叶1例,平均肿瘤大小(286.34±23.75)mm3,形态规则10例,边界清晰9例,瘤内坏死囊变11例;不伴畸胎样混合型9例,其中肿瘤位于肝右叶4例,左右叶2例,左叶2例,尾状叶1例,平均肿瘤大小(282.59±21.98)mm3,形态规则6例,边界清晰5例,瘤内坏死囊变7例;伴畸胎样混合型14例,其中肿瘤位于肝右叶8例,位于左右叶3例,左叶2例,尾状叶1例,平均肿瘤大小(284.61±22.07)mm3,形态规则11例,边界清晰10例,瘤内坏死囊变12例.不同病理类型肝母细胞瘤肿瘤位置、大小、形态、边界及瘤内坏死囊变占比比较差异均无统计学意义.完全上皮细胞型、不伴畸胎样混合型、伴畸胎样混合型肿瘤内部回声和钙化情况比较差异均有统计学意义(均P<0.05);其中完全上皮细胞型肿瘤内部强回声占比高于不伴畸胎样混合型和伴畸胎样混合型,不伴畸胎样混合型肿瘤内部强回声占比高于伴畸胎样混合型,完全上皮细胞型肿瘤钙化占比低于不伴畸胎样混合型和伴畸胎样混合型,差异均有统计学意义(均P<0.05).结论 不同病理类型儿童肝母细胞瘤内部强回声和钙化均存在差异,其可为临床初步判断肝母细胞瘤患儿病理分型提供参考依据.
Abstract
Objective To analyze the ultrasonic manifestations of hepatoblastoma with different pathological types in children.Methods A retrospective analysis was performed on the ultrasonic and pathological data of 36 children with hepatoblastoma admitted to our hospital.The ultrasonic findings of hepatoblastoma with different pathological types(complete epithelial cell type,non-teratoid mixed type,teratoid mixed type)in children were summarized.Results Among the 36 children with hepatoblastoma,there were 13 cases with complete epithelial cell type,of which 7 cases with tumors located in right lobe of liver,3 cases in left and right lobes,2 cases in left lobe and 1 case in caudal lobe.The average size of tumors was(286.34±23.75)cm3.There were 10 cases with regular lesions,9 cases with boundary-clear lesions and 11 cases with necrosis and cystic lesions in tumors.Among the 9 cases with non-teratoid mixed type,there were 4 cases with tumors located in right lobe of liver,2 cases in left and right lobes,2 cases in left lobe and 1 case in caudal lobe.The average size of tumors was(282.59±21.98)cm3.There were 6 cases with regular lesions,5 cases with boundary-clear lesions and 7 cases with necrosis and cystic lesions in tumors.Among the 14 cases with teratoid mixed type,there were 8 cases with tumors located in right lobe of liver,3 cases in left and right lobes,2 cases in left lobe and 1 case in caudal lobe.The average size of tumors was(284.61±22.07)cm3.There were 11 cases with regular lesions,10 cases with boundary-clear lesions and 12 cases with necrosis and cystic lesions in tumors.There were no statistically significant difference in tumor location,size,shape,boundary,and proportion of intratumoral necrotic cysts among different pathological types.There were statistically significant differences in internal strong echo and calcification among tumors with complete epithelial cell type,non-teratoid mixed tpye,and teratoid mixed type(all P<0.05).Of which the proportion of internal strong echo in complete epithelial cell type tumors was higher than that of non-teratoid mixed type and teratoid mixed type tumors,and which in non-teratoid mixed type tumors was higher than that in teratoid mixed type tumors(all P<0.05).The proportion of calcification in complete epithelial cell type tumors was lower than that of non-teratoid mixed type tumors and teratoid mixed type tumors(both P<0.05).Conclusion There are differences in proportions of strong echo and calcification among children with different types of hepatoblastoma,which can provide a clinical reference for preliminary determination of pathological types of hepatoblastoma.
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