小儿神经母细胞瘤特殊Ⅳ期的超声诊断价值及特征

目的:探讨小儿神经母细胞瘤特殊Ⅳ期(4sNB)的超声诊断价值及图象特征,以提高超声诊断水平。方法:回顾分析12例经手术病理证实的4sNB的超声表现特点。结果:原发瘤呈圆形或类圆形,边界清晰。肿瘤回声不均或欠均匀,中等回声为主7例,低回声为主4例,高回声为主1例。内部可见强回声光团或光点4例,1例可见小囊区。肝脏改变:肝巨大11例,1例肝不大。肝内呈弥漫密集大小不等中低回声结节11例,呈高回声结节1例。肝不大者以右睾丸转移为主要表现。腹膜后未探及肿大淋巴结。6例行CT检查,5例检出原发瘤,4例检出肝内转移灶。结论:4sNB原发瘤较小位于肾上腺,呈圆形或类圆形,超声很容易发现。绝大多数肝脏明显增大,肝内转移灶呈不规则形或球形弥漫低回声结节,亦可呈细小点状,少数为高回声结节。除肝转移外亦可睾丸转移。本病超声诊断简便准确,不需鉴别,并优于CT。

Ultrasonic Value and Features of Stage 4S Neuroblastoma

Objective:To study the ultrasonographic value and characteristics of Stage 4S neuroblastoma so as to elevate the diagnostic accuracy.Methods:Sonographic features of 12 cases of stage 4S neuroblastoma proved by operation and pathology were studied retrospectively.Results:The primary tumor of adrenal gland was almost round with well-defined and inhomogeneous echogenicity,midechogenicity in 7,hypoechogenicity in 4,hyperechogenicity in 1,calcification in 4,small cyst in 1.The liver was found to be markedly enlarged in 11,and multiple round or irregular echogenic lesions distributed throughout the liver parenchyma.Hypogenicity node in 11,hypergenicity in 1.One case whose liver did not enlarge metastasize to testis.There was no enlarged lymph node in retroperitoneum in 12.CT scan was developed in 6.Primary tumor could be found in 5,liver metastases was detected in 4.Conclusion:The diagnosis of stage 4S neuroblastoma is made on the basis of the primary tumor in adrenal gland and enlargement of the liver with echogenic metastases.The primary tumor is small and it is easy to be detected by ultrasound scan.Almost all cases of stage 4S neuroblastoma are complicated by severe hepatomegaly and diffused metastases.It is very rare to metastasize to the testis.Ultrasound scan is very helpful,it is a convenient and accurate imaging tool and need no differential diagnosis.