摘要
目的探讨多层螺旋CT(MSCT)对儿童Wilms瘤诊断的应用价值。方法回顾性分析45例经手术、病理证实为Wilms瘤的MSCT表现。全部病例均行平扫与增强扫描,并行多平面重建(MPR)、最大密度投影(MIP)。结果肿瘤单侧多见,也可双侧。上极多于下极。肿瘤不均匀强化,常伴坏死、出血、囊变,少数有钙化;残存肾呈"新月形"强化,为典型CT表现,肿块可跨过中线,但不包绕腹膜后大血管。本组术前定性诊断准确率为97%,腹膜后、膈脚后淋巴结转移最多见。通过MPR、MIP重建可清晰显示血管受累情况。结论 MSCT检查可较准确对Wilms瘤定性,结合肿瘤范围、周围血管受累以及转移情况,对肿瘤分期、手术治疗及预后有重要意义。
Objective To discuss the diagnostic value of the multislice spiral CT （MSCT ） in the nephro-blastoma （Wilms′ tumor） .Methods CT imaging cases of 45 patients with pathology proven nephroblastoma were retrospectively analyzed .All patients were performed MSCT volume scanning involving contrast-enhanced MSCT scanning with multiple planar reconstruction （MPR） and maximum intensity projection （MIP） .Results Most Wilms′ tumors were unilateral ,although they may occasionally be bilateral in origin . The appearance of Wilms′tumor in the upper pole of the kidney was more often than that in the lower pole .CT scan with contrast enhancement showed that the tumor was not uniform enhancement , often with necrosis , hemorrhage , cystic change ,and a few had calcification .Typical radiographic findings in patients with Wilms′ tumor showed the re-maining kidney had crescent-shaped enhancement .The tumor location can cross the body center line ,but not cross around the retroperitoneal main blood vessels .The preoperative qualitative diagnostic accuracy rate of this group is 97% ,and metastasis is seen mostly in the lymph node retroperitoneal and posterior to diaphragmatic crus .The performance of the vascular involvement can be displayed clearly through MPR and MIP reconstruction .Conclusion MSCT scan may be more accurate to Wilms′tumor on qualitative analysis ,and may have important significance on tumor staging ,operation and prognosis according to the tumor range and the performance of the vascular in-volvement and lesion metastasis .
出处
《山西医药杂志（上半月）》
CAS
2013年第11期1213-1215,共3页
Shanxi Medical Journal
基金
国家自然科学基金青年科学基金(81202032)
