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目的探讨儿童肾脏和腹膜后肿瘤的CT诊断及鉴别诊断。方法回顾性分析189例儿童肾脏和腹膜后肿瘤的CT表现。所有病例均经手术病理证实,其中肾母细胞瘤71例(73个肿瘤),神经源性肿瘤89例(成神经细胞瘤70例,神经节成神经细胞瘤2例,神经节细胞瘤17例),畸胎瘤18例,淋巴瘤11例。结果肾母细胞瘤CT表现为圆形或类圆形的有包膜肿块,常引起肾脏破坏,残肾呈新月形包绕肿块,易形成肾静脉、下腔静脉瘤栓及肺内转移。成神经细胞瘤与神经节成神经细胞瘤表现类似,多有钙化及血管包埋等征象,可侵犯肾脏,以淋巴结、颅脑、骨骼及肝脏转移常见;神经节细胞瘤表现为肾上腺区或脊柱旁体积较小的卵圆形低密度肿块,增强早期无强化或轻微强化。淋巴瘤发生于中线附近,呈分叶状多中心融合病灶,血管包埋较松散,侵犯肾脏多为双侧。畸胎瘤发生于一侧腹膜后,钙化或骨化以及脂肪密度是其特征。结论CT对儿童肾脏和腹膜后肿瘤具有较高的诊断和鉴别诊断价值。
Objective To investigate the CT diagnosis and differential diagnosis of children’s kidney and retroperitoneal tumor. Methods A retrospective analysis of 189 cases of children with renal and retroperitoneal tumor CT manifestations. All cases were confirmed by surgery and pathology, including 71 cases of nephroblastoma (73 tumors), 89 cases of neurogenic tumors (70 cases of neuroblastoma, 2 cases of ganglioneuroblastoma, 17 cases of ganglioneuroma ), Teratoma in 18 cases, lymphoma in 11 cases. Results Renaloblastoma CT showed round or oval capsule mass, often causing kidney damage, residual kidney was crescent-shaped mass, the formation of renal vein, inferior vena cava tumor thrombus and pulmonary metastasis. Neuroblastoma and ganglion neuroblastoma performance similar to many calcifications and vascular embolism and other signs of violations of the kidney to lymph nodes, brain, bone and liver metastasis common; ganglioneuroma showed adrenal area or the spine Next to the smaller volume of oval low-density mass, enhanced early no enhancement or slight enhancement. Lymphomas occur near the midline, lobulated multicentric fusion lesions, vascular embedding more loose, mostly infringe the kidney bilateral. Teratoma occurs on one side of the retroperitoneum, with calcification or ossification as well as fat density. Conclusion CT in children with renal and retroperitoneal tumors with high diagnostic and differential diagnosis.