摘要
目的评价儿童腹膜后成神经细胞瘤侵犯肾脏与肾母细胞瘤的CT表现鉴别要点。方法分析经手术证实的有明确肾脏侵犯13例腹膜后成神经细胞瘤的CT征象,并与同期经手术证实的15例肾母细胞瘤进行对照。结果13例成神经细胞瘤中12例表现为不规则肿块,11例边界不清,10例包含钙化,9例腹膜后血管受侵犯,12例有腹膜后和膈脚后淋巴结转移;15例肾母细胞瘤中,12例呈圆形肿块,2例边界不清,2例有钙化,2例腹膜后血管受侵犯,3例有腹膜后淋巴结转移;无膈脚后淋巴结转移表现。其中神经母细胞瘤的肿瘤分叶征、钙化、腹膜后和膈脚后淋巴结转移、腹主动脉和下腔静脉包埋均较肾母细胞瘤常见。其中膈脚后淋巴结转移和腹膜后血管包埋对于诊断神经母细胞瘤具有较高价值。结论膈脚后淋巴结转移和腹膜后血管包埋是成神经细胞瘤的特征性表现,对于鉴别腹膜后成神经细胞瘤与肾母细胞瘤具有重要的意义。
Objective To evaluate the CT findings in the differential diagnosis between neuroblastoma invading the kidney and nephroblastoma. Methods CT morphologic details in 13 patients with neuroblastoma invading the kidney confirmed by surgical operation and pathology were studied, and CT findings in 15 patients with nephroblastoma confirmed by surgery and pathology were compared. Results In 13 cases of neuroblastoma, CT showed irregular mass in 12 cases, tumor with poorly defined margins in 11 cases, tumorous calcifications in 10 cases, invasion of retroperitoneal vessels in 9 cases, and retroperitoneal and retrocrural lymph nodes invasion in 12 cases. In 15 cases of nephroblastoma, round mass was presented in 12 cases, tumor with poorly defined margins in 2 cases, tumorous calcifications in 2 cases, involvement of retroperitoneal vessels in 2 cases, and invasion of retroperitoneal lymph nodes in 3 cases. None of the nephroblastoma invaded retrocrural lymph nodes. Irregular mass with calcifications, involvement of retroperitoneal vessels, retrocrural and retroperitoneal lymph nodes were more common in cases of neuroblastoma than in nephroblastoma. Moreover, involvement of retrocrural lymph nodes and encasement of retroperitoneal vessels had higher positive prediction value on neuroblastoma. Conclusion Involvement of retrocrural lymph nodes and encasement of retroperitoneal vessels were the specific CT findings of neuroblastoma and the most valuable evidence in distinguishing neuroblastoma from nephroblastoma.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第7期747-750,共4页
Chinese Journal of Radiology
