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目的 探讨儿童肾脏恶性肿瘤的CT表现及特点。材料与方法 回顾性分析 5 3例经临床病理证实的小儿肾脏恶性肿瘤 ,其中Wilms瘤 45例 ,肾透明细胞肉瘤 3例 ,肾细胞癌 3例 ,肾恶性横纹肌样瘤、肾胚胎性横纹肌肉瘤各 1例。结果 45例Wilms瘤中 76 %呈实质性肿块 ,4%为囊性 ,2 0 %为囊实性 ;增强后肿瘤实质部分、囊壁及间隔有强化 ;9%见斑点或斑片状钙化。肾脏恶性非Wilms瘤在CT上表现为边界清晰或模糊的类球形、密度欠均匀的实质性肿块 ,增强后轻～中等度强化 ,8例中 5例 ( 6 3% )见斑点或斑片状钙化。肾恶性横纹肌样瘤见实质内点状及条索状强化血管影。肾胚胎性横纹肌肉瘤表现为肾实质及肾盂内分叶状实质性肿块 ,侵犯肾门及输尿管上段 ,肾周见新月形低密度的包膜下积液。结论 CT对儿童肾脏恶性肿瘤的术前诊断及提出随访方案上有一定帮助。
Objective To investigate the CT features and features of children with renal malignancies. Materials and Methods Retrospective analysis of 53 cases of clinically and pathologically confirmed pediatric renal malignancies, including 45 cases of Wilms tumor, 3 cases of renal clear cell sarcoma, 3 cases of renal cell carcinoma, renal malignant rhabdomyosarcoma, renal rhabdomyosarcoma 1 case. RESULTS: 76% of 45 Wilms tumors were cystic, 4% cystic and 20% cystic solid. After enhancement, the solid part of the tumor showed enhanced cyst wall and septum and 9% showed spotted or patchy calcification. Malignant non-Wilms tumor of the kidney showed clear or obscure spheroidal, densified, homogeneous masses on CT with enhanced mild to moderate enhancement. In 8 cases, 5 cases (63%) showed spots or patchy Calcification. Malignant rhabdomyosarcoma see parenchymal plicate and cord-like enhancement of blood vessels. Renal embryonal rhabdomyosarcoma showed renal parenchyma and renal pelvis lobulated mass, renal and ureter violations of the upper renal cortex, see the crescent-shaped low-density subependymal effusion. Conclusion CT is helpful to preoperative diagnosis of renal neoplasm in children and follow-up plan.