摘要
目的探讨MRI对儿童纵隔神经节源性肿瘤的诊断及鉴别诊断价值,提高其术前诊断准确水平.方法回顾性分析41例经病理证实的儿童纵隔神经节源性肿瘤[节细胞神经瘤GN 19例、节细胞神经母细胞瘤(GNB)6例,神经母细胞瘤(NB)16例]的MRI特点及临床病理学特征,包括发病年龄、病变大小、肿瘤形态及边界、MRI平扫及增强信号特点等,并与术后病理进行对照,对所获得数据进行统计学分析,计数资料比较采用Fisher精确检查,计量资料采用单因素方差分析,组间比较用SNK-q检验,P<0.05为差异有统计学意义.结果 19例GN平均发病年龄为3.9岁,肿瘤最大径(7.3 ±2.7) cm,肿瘤形态规则12例,边界清18例,肿瘤与椎管相通11例,肿瘤呈多结节融合状0例,肿瘤呈纵长12例,平扫T1 WI呈低信号11例,T2 WI呈均匀高信号12例,肿瘤伴出血坏死囊变2例,增强后呈轻度强化9例,肿瘤包膜完整13例,发生转移0例;6例GNB和16例NB出现上述征象者分别为:4.1岁,1.9岁;(6.8 ±2.6)cm,(6.4 ±2.5)cm;2例,6例;5例, 12例;3例,15例;2例,10例;3例,12例;0例,4例;3例,9例;2例,11例;1例,2例;5例,9例;0例,7例;在发病年龄(F=4.145,P=0.024)、肿瘤与椎管关系( P=0.023)、肿瘤伴出血坏死囊变( P=0.001)、肿瘤呈多结节融合状(P=0.000)、平扫T1 WI信号(P=0.015)、伴发转移(P=0.000)等方面进行比较,均差异有统计学意义(P<0.05).而在肿瘤最大径(F=0.363,P=0.698)、肿瘤形态(P=0.277)、边界(P=0.221)、纵长生长(P=0.401)、平扫T2 WI信号(P=0.835)、强化程度(P=0.338)、肿瘤有无包膜(P=0.423)等方面均差异无统计学意义,(均P>0.05).结论良性GN发病年龄较NB明显偏大,T1WI平扫多呈低信号,增强后以轻度强化为主,GNB和NB的肿瘤形态不规则,NB以多结节融合状为主,易发生出血坏死囊变,T2 WI以混杂高信号为主,多呈中度或明显不均匀强化,NB容易侵犯到椎管内及发生远处转移.
Objective In order to improve the accuracy of preoperative diagnosis, the value of MRI in the diagnosis and differential diagnosis of the mediastinal neuroganglionic tumors in children was explored. Methods A retrospective analysis of 41 cases of pathologically proven mediastinal neuroganglionic tumors[GN 19 cases, 6 cases of ganglion neuroblastoma (GNB), 16 cases of neuroblastoma (NB)]was conducted.The MRI characteristics and clinicopathological features were analyzed, including age, size, shape and boundary of tumor, MRI plain scan and enhanced signal characteristics, compared with postoperative pathology. Results The average age of the 19 cases of GN was 3.9 years, the maximum diameter of the tumor was 7.3 cm, 12 cases of tumor morphology, 18 cases of clear border, 11 cases of tumor interlinking with vertebral canal, 0 case with multi nodular fusion, 12 cases with lengthwise tumor, 11 cases with low signal in T1WI, 12 cases of uniform high signal in T2WI, and 2 cases with hemorrhagic necrotic cysts and cystic degeneration.In 6 cases of GNB and 16 cases of NB, the above-mentioned signs were 4.1 years old, 1.9 years old, 6.8 cm, 6.4cm, 2, 6;5, 12;3, 15;2, 10;3, 12;0, 4;3, 9;2, 11;1, 2;5, 9;0, 7, there were statistically significant differences in age of onset(F=4.145;P=0.024), relationship between tumors and vertebral canal(P=0.023), hemorrhagic necrosis and cystic degeneration(P=0.001), multiple nodule fusion(P=0.000), plain T1WI signal(P=0.015), and associated metastasis(P=0.000). There were no statistically significant differences in tumor size(F=0.363;P=0.698), tumor shape(P=0.277), boundary(P=0.221), lengthwise growth(P=0.401), plain scan T2WI signal(P=0.835), intensifying degree(P=0.338), whether the tumor had capsule(P=0.423). Conclusion The onset age of benign GN is significantly larger than that of NB, T1WI plain scan is mostly low signal, after enhancement, mainly with mild strengthening, GNB and NB tumor shape is irregular, NB is mainly multi nodular fusion, which easy to occur hemorrhage and necrosis
作者
徐树明
白娟
何玲
Xu Shuming;Bai Juan;He Ling(Medical Imaging Center,Children′s Hospital of Shanxi,Taiyuan,Shanxi 030013,China;School of Medical Imaging,Shanxi Medical University,Taiyuan,Shanxi,030001,China;Department of Radiology,Children′s Hospital Affiliated to Chongqing Medical University,Chongqing,400014,China)
出处
《中国基层医药》
CAS
2019年第20期2488-2493,共6页
Chinese Journal of Primary Medicine and Pharmacy
基金
山西省2015年留学回国人员科技活动择优资助项目(晋人社厅函[2016]97号).
关键词
肿瘤
神经上皮
神经节源性肿瘤
儿童
纵隔
磁共振成像
鉴别诊断
回顾性
病理学
交感神经节
Neoplasms, neurotpitelial
Neuroganglionic tumors
Children
Mediastinum
Magnetic resonance imaging
Differential Diagnosis
Retrospective
Pathology
Sympathetic Ganglion
