本文關(guān)鍵詞：PRETEXT分期系統(tǒng)結(jié)合影像學(xué)特點在兒童肝母細(xì)胞瘤治療評價中的應(yīng)用價值研究　出處：《中國醫(yī)學(xué)計算機成像雜志》2017年04期 　論文類型：期刊論文

  更多相關(guān)文章： 肝臟 兒童 肝母細(xì)胞瘤 CT PRETEXT分期

【摘要】：目的:對CT肝臟功能分段法及PRETEXT分期系統(tǒng)并結(jié)合影像學(xué)特點,在兒童肝母細(xì)胞瘤(hepatoblastoma,HB)治療中的有效性進(jìn)行評價。方法:回顧性分析2012年7月至2016年9月經(jīng)CT診斷的兒童肝母細(xì)胞瘤共36例,分析其臨床資料和影像表現(xiàn),使用CT斷層功能分段法及PRETEXT分期對36例腫瘤進(jìn)行分期,結(jié)合影像特點,采用相應(yīng)的治療方案進(jìn)行治療,對36例病例的治療效果進(jìn)行分析。所有病例均經(jīng)病理證實。結(jié)果:36病例:(1)影像特點:平掃期腫塊密度較正常肝臟實質(zhì)稍低,含有鈣化的18例,占50%;2例增強后動脈期明顯強化,病理為純胎兒型;3例增強后呈極輕度強化,為小細(xì)胞未分化型;31例增強后呈輕度至中度不均勻強化,為上皮混合型14例及上皮間葉混合型17例。(2)CT PRETEXT分期:Ⅰ期5例,Ⅱ期12例,Ⅲ期17例,Ⅳ期2例;根據(jù)手術(shù)結(jié)果再次使用PRETEXT分期法進(jìn)行分期,Ⅰ期5例,Ⅱ期8例,Ⅲ期22例,Ⅳ期1例,總體準(zhǔn)確率為86.1%(31/36)。(3)治療效果評價:根據(jù)PRETEXT分期結(jié)合CT表現(xiàn),Ⅰ期5例和Ⅱ期6/8例直接手術(shù)切除;Ⅱ期2/8例由于伴有腹水、肺部轉(zhuǎn)移和門靜脈瘤栓,與Ⅲ期22例和Ⅳ期1例先行活檢。11/13例直接手術(shù)切除病例,2例隨訪復(fù)查無明顯復(fù)發(fā)征象,9例行化療鞏固治療,無明顯異常;25/36例病例經(jīng)2個化療期后,均顯示瘤體有不同程度的縮小,但所占肝臟的分段不變,隨后對腫塊進(jìn)行手術(shù)切除。結(jié)論:PRETEXT分期系統(tǒng)對肝母細(xì)胞瘤治療方案選擇有重要的指導(dǎo)價值,結(jié)合腫瘤影像學(xué)的特點,對本病進(jìn)行合理的評估,從而為腫瘤手術(shù)時機及化療方案的調(diào)整提供幫助。
[Abstract]:Objective: to study the application of CT and PRETEXT staging system in hepatoblastoma in children with hepatoblastoma. Methods: the clinical data and imaging findings of 36 children with hepatoblastoma diagnosed by CT from July 2012 to 2016 were analyzed retrospectively. Ct tomography and PRETEXT staging were used to staging 36 cases of tumors. According to the imaging features, the corresponding treatment scheme was used. The therapeutic effects of 36 cases were analyzed. All the cases were confirmed by pathology. Results the imaging features of 1 / 36 cases were as follows: mass density in plain scan was slightly lower than that in normal liver, and calcification was found in 18 cases. 50%; In 2 cases, the enhancement of posterior artery phase was obvious, and the pathology was pure fetal type. 3 cases showed very slight enhancement after enhancement, which was small cell undifferentiated type. 31 cases showed mild to moderate heterogeneous enhancement after enhancement, including 14 cases of epithelial mixed type and 17 cases of mixed epithelial lobe type. Ct PRETEXT staging: stage 鈪，

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