摘要
目的：探讨ＣＴ对儿童神经母细胞瘤的诊断价值。材料与方法：分析经手术、病理证实的２６例神经母细胞瘤的ＣＴ表现，其中：神经母细胞瘤２１例，神经节神经母细胞瘤５例。胸部７例（２７％），肾上腺１６例（６２％），腹部、盆腔交感神经链３例（１１％）。全部病例行ＣＴ平扫与增强检查。结果：肾上腺和后纵隔近头端为本组两个最好发部位。肿瘤钙化发生率为７３％，肿瘤大小与钙化无关，神经母细胞瘤钙化明显多于神经节神经母细胞瘤，转移瘤可发生钙化。强化程度与瘤细胞分化程度相关。肿瘤向椎管内延伸２例，肾上腺神经母细胞瘤侵袭同侧肾脏７例，侵袭肝脏３例，肝转移１例，淋巴结转移１９例。１３例患者尿３－甲氧－４－羟苦杏仁酸（ＶＭＡ）阳性。本组术前诊断准确率为９２％。结论：ＣＴ是诊断儿童神经母细胞瘤最有价值的检查方法之一，好发部位、钙化、早期发生淋巴结转移，以及血、尿ＶＭＡ增高是诊断的重要依据。ＣＴ表现可为术前定性诊断、确定治疗方案及估计预后提供重要依据。
Purpose: To evaluate CT in the diagnosis of neuroblastoma in childhood. Materials and methods: Analysis of CT manifestations in 26 cases proved by operation and pathology, including neuroblastoma 21 cases, ganglioneuroblastoma 5 cases. Thorax 7 cases (27%), adrenal gland 16 cases (62%), abdomenpelvis paravertebral sympathetic chain 3 cases (11%). Bolus injection of contrast medium was given in all cases. Results: Adrenal gland and posterior superior mediastinum were the most common sites for neuroblastoma. 73% of neuroblastoma had calcifications. Neuroblastoma was more commonly calcified than ganglioneuroblastoma. Metastases were also calcified. Degree of enhancement was associated with the type of neuroblastoma. Tumor extension into the spinal canal was seen in 2 cases. 43% neuroblastoma of adrenal directly invaded the kidney in 7 cases. Right lobe of liver was involved in 3 cases, metastases to liver in 1 case, enlargement of lymph nodes 19 cases. Approximately 68% of patients showed increase of urinary Vanillymandelic acid (VMA). Preoperative diagnostic accuracy was 92%. Conclusion: CT is recognized as a useful technique for the diagnosis of neuroblastoma. The site of predilection, calcification, lymph node metastases and VMA increase in urine or serum are important basis for diagnosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1997年第12期814-817,共4页
Chinese Journal of Radiology
关键词
神经母细胞瘤
CT
儿童
Neuroblastoma Tomography, X-ray computed Children
