摘要
目的探讨CT对儿童纵隔神经母细胞瘤（NB）与节细胞神经母细胞瘤（GNB）的鉴别诊断价值。方法回顾性分析经手术病理证实的26例纵隔NB和15例GNB患儿的临床资料及CT表现,采用χ2检验或Fisher精确检验比较病灶的形状、边界、密度、有无钙化、钙化形态、有无囊变坏死、对周围器官的压迫或包绕、局部侵犯及转移、越中线生长、胸腔积液及胸膜增厚及病灶的强化方式,采用Student t检验比较病灶的大小及各期CT值。结果NB及GNB纵径均值（82.4 mm、67.9 mm）大于其轴位长径（59.1 mm、52.9 mm）及短径（46.9 mm、39.5 mm）,差异均有统计学意义（均P〈0.05）。76.92%（20/26）NB与33.33%（5/15）GNB边界不清,61.54%（16/26）NB与26.67%（4/15）GNB出现转移或局部侵犯,两者比较差异均有统计学意义（P=0.006,0.031）。病灶大小、形态、密度、有无钙化、钙化形态、有无囊变坏死、对周围器官的压迫或包绕、越中线生长、胸水及胸膜增厚及病灶的强化方式在NB与GNB的比较中,差异均无统计学意义。增强后比较,GNB各期CT值均低于NB,但差异无统计学意义。NB动脉期较平扫CT值增加量、静脉期较动脉期CT值增加与GNB比较（16.5 HU vs.9.0 HU,17.3±12.9 HU vs.27.1±16.7 HU）,差异均有统计学意义（P=0.035,0.038）。结论部分CT征象有助于鉴别儿童NB与GNB,NB病灶常边界不清,内多见无定形、杂乱、粗大钙化,易局部侵犯及转移,动脉期强化明显,GNB病灶多边界清,多见点状、斑片状及环形钙化,少见侵犯及转移征象,静脉期强化明显。
Objective To evaluate the value of CT in differential diagnosis between mediastinal neuroblastomas（NB）and ganglioneuroblastomas（GNB） in children.Methods The clinical data and CT findings of 26 cases of mediastinal NB and 15 cases of GNB diagnosed by pathology were retrospectively analyzed.The shape,boundary,density,presence or absence of calcification,and calcification morphology were compared with Chi-square test or Fisher＇s exact test.No cystic necrosis,oppression or entrapment of surrounding organs,local invasion and metastasis,hypermedial growth,pleural effusion and pleural thickening,and enhancement of lesions were performed.Student t-test was used to compare the size of lesions and CT values at each stage.Results The mean diameters of NB and GNB（82.4 mm,67.9 mm） were greater than the long axis（59.1 mm,52.9 mm） and short diameter（46.9 mm,39.5 mm） of NB and GNB,and the differences were statistically significant（all P〈0.05）..76.92%（20/26） NB and 33.33%（5/15） GNBs have unclear boundaries,61.54%（16/26） NBs and 26.67%（4/15） GNBs have metastasis or local invasion.Statistical significance（P = 0.006,0.031）.Lesion size,morphology,density,presence or absence of calcification,calcification,cystic necrosis,compression or entrapment of surrounding organs,hypermedial growth,pleural effusion and pleural thickening,and enhancement of lesions in the comparison of NB and GNB The difference was not statistically significant.After the enhancement,the CT values of GNB in each period were lower than NB,but the difference was not statistically significant.Compared with GNB（16.5 HU vs.9.0 HU,17.3 ± 12.9 HU vs.27.1 ± 16.7 HU）,the increase in the CT value of the NB arterial phase compared with the plain scan was statistically significant（P〈0.05）.= 0.035,0.038）.Conclusion Some CT signs are helpful to identify children with NB and GNB.The borders of NB lesions are often unclear.Amorphous,clutter,and coarse calcification are frequently seen in the lesions.Local invasion and m
作者
王攀鸽
梁盼
谭红娜
王博
高剑波
WANG Pange;LIANG Pan;TAN Hongna(Department of Radiology, the First Hospital Affiliated Zhengzhou University, Zhengzhou 450052, P. R. Chin)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第5期837-841,共5页
Journal of Clinical Radiology
