小儿盆腔恶性肿瘤的CT诊断

目的总结小儿盆腔恶性肿瘤CT表现，提高CT诊断及鉴别诊断的准确性。方法回顾性分析52例经手术病理证实的盆腔恶性肿瘤的影像学资料。全部病例行CT平扫及增强扫描，部分病例作过静脉尿路造影和，或膀胱造影检查。结果CT表现（1）内胚窦瘤17例：瘤体较大，平扫密度均匀与不均匀各占约54％和46％，增强扫描呈轻中度一高度强化并存。大部分病例可见较小范围坏死囊变区域，多数侵犯邻近组织。（2）横纹肌肉瘤16例：多数边缘清楚，密度较均匀，呈轻中度不均匀强化或无强化。（3）恶性畸胎瘤14例，瘤体巨大，为实性混杂密度，呈轻中度强化，邻近脏器未受侵。其中钙化14例，脂肪组织12例，（4）其他肿瘤5例：神经母细胞瘤2例，密度不均匀，可见囊变坏死区。神经节神经母细胞瘤1例，密度均匀，未见囊变坏死区。非霍奇金淋巴瘤2例，密度均匀，无钙化，呈轻中度强化，无囊变坏死区。结论CT检查是发现和诊断盆腔恶性肿瘤的重要检查手段，可初步判断肿瘤类型，有助于临床选择合理的治疗方法。

Diagnosis of pediatric malignant pelvic tumors by spiral CT

Objective To analyze the features of pediatric malignant pelvic tumors by spiral CT and improve its accuracy of differential diagnosis. Methods The CT appearance from 52 cases of pediatric malignant pelvic tumors pathologically proved were analyzed retrospectively. Plain and contrast CT scans were performed in all patients, while IVP and/or cystography examination were carded out in some. Results （1）Endodermal sinus tumor（17 case）： Inhomogeneous and homogeneous dense major mass accounted for 54% and 46% respectively on plain scan. The tumor showed moderate to high heterogeneous enhancement, cystis degeneration and encroachment on adjacent tissue were found in most cases. （2）Rhabdomyosarcoma （16 cases）： Most have distinct margin and uniform density with slight to moderate enhancement or without enhancement. （3） Malignant teratoma （14cases）： They showed as solid miscellaneous dense huge mass, and slight to moderate enhancement without invasion. Calcification was found in 14 cases and adipose tissue in 12 cases.（4）other tumors （5 cases）： The density was heterogeneous in 2 cases of neuroblastoma with cystis degeneration and was homogeneous in 1 case of ganglioneuroblastoma. Homogeneous density and slight to moderate enhancement were found in 2 cases of non- Hodgkin lymphoma without calcification and cystic degeneration. Contusion CT scan is an important tool in finding and diagnosing malignant pelvic tumors. It can be helpful to define the classification of tumor and determine reasonable treatment.