儿童腹膜后肾周间隙肾脏肿瘤与肾周肿瘤的多层螺旋CT对照研究

目的 探讨儿童腹膜后肾周间隙肾脏与肾周起源肿瘤的主要CT征象及鉴别诊断.方法 收集经手术病理证实的儿童腹膜后肾周间隙肿瘤40例,以病理结果为依据,将其分为肾脏肿瘤组(n=14)和肾周肿瘤组(n=26),并对其CT表现及相关临床资料进行了对照分析.结果 肾脏肿瘤组的定位及起源征象以"新月征"、"鸟嘴征"、"肾脏嵌入征"、"肿瘤供血动脉征"多见,而肾周肿瘤组以肾脏移位伴肾轴旋转、肿瘤中心层面位于肾轮廓外多见.肾脏肿瘤组肿瘤的主要CT征象以"假包膜"、"囊变、坏死"、肿瘤血管丰富、下腔静脉内瘤栓及远处转移多见,而肾周肿瘤组以"分叶征"、"瘤内钙化"多见.结论 多排螺旋CT增强扫描可用于儿童腹膜后肿瘤的位置、起源及肿瘤的组织学特征的观察,其相应的CT征象有助于儿童腹膜后肾周间隙肾脏与肾周起源肿瘤的鉴别.

Renal and Non-renal Tumors within the Perirenal Space in Infants and Children: Multi-detector Row CT Characteristics

Objective To determine the characteristics of Multi-detector Row CT (MDCT) image in distinguishing renal tumors from non-renal tumors within the perirenal space in infants and children. Methods Data from 40 patients with surgically and pathologically proved retroperitoneal neoplasms within the perirenal space were collected. Based on the pathological findings, the patients were divided into renal tumor group (n=14) and non-renal tumor group (n=26). The major clinical characteristics and CT characteristics of the two groups were compared. Results Incomplete renal contour with "crescent sign", "beak sign","embedded kidney sign" and "prominent feeding artery sign" appeared in renal tumors more often than in non-renal tumors(P<0.05). The sign of "renal displacement and renal axis rotation" and "extra-renal central plane of tumor" appeared more often in non-renal tumors than in renal tumors (P<0.05). Large solid tumors with "pseudocapsule", "necrosis and cystic change", "vascularity", inferior vena cava tumor thrombus, and distant metastasis were more likely to be renal tumors than non-renal tumors(P<0.05). Irregular mass with calcifications appeared more often in non-renal tumors than in renal tumors (P<0.05). Conclusion MDCT can detect the location, origin and histological feature of retroperitoneal neoplasms in infants and children. The MDCT characteristics can help differentiate renal and non-renal tumors within the perirenal space.