本文關(guān)鍵詞： 兒童 骶尾部 生殖細(xì)胞瘤 惡性 體層攝影術(shù) 螺旋計(jì)算機(jī)　出處：《放射學(xué)實(shí)踐》2015年02期 　論文類(lèi)型：期刊論文

【摘要】：目的:評(píng)估MSCT對(duì)小兒骶尾部惡性生殖細(xì)胞瘤的診斷價(jià)值。方法:回顧性分析9例經(jīng)影像臨床及病理證實(shí)的小兒骶尾部惡性生殖細(xì)胞瘤的MSCT表現(xiàn)、病理學(xué)及臨床特征。9例患兒中男5例,女4例,年齡5個(gè)月~4歲,中位年齡16個(gè)月。9例血清AFP均升高,明顯升高者(300ng/mL)8例(8/9)。所有患兒術(shù)前均行MSCT增強(qiáng)檢查,并根據(jù)腫瘤的MSCT表現(xiàn),按照Altman分型系統(tǒng)進(jìn)行分類(lèi),分析其大小、形態(tài)、密度、血運(yùn)、轉(zhuǎn)移情況及血清AFP值。結(jié)果:本組9例患兒中Ⅱ型1例,Ⅲ型3例,Ⅳ型5例。腫瘤均較大(42mm×43mm~132mm×21mm),實(shí)性腫瘤居多(5/9)。腫瘤密度不均勻,無(wú)脂肪成分或僅含有點(diǎn)狀脂肪成分腫瘤7例,9例腫瘤均可見(jiàn)豐富血運(yùn),增強(qiáng)后呈不均勻明顯強(qiáng)化,且均可見(jiàn)局部浸潤(rùn)或遠(yuǎn)處器官轉(zhuǎn)移,其中骶骨及椎體骨破壞最常見(jiàn)(8/9);其次為下腔靜脈或髂靜脈瘤栓(6/9);亦可見(jiàn)肝、肺轉(zhuǎn)移及椎管浸潤(rùn)等。術(shù)前CT正確診斷8例(8/9),其診斷符合率為89%;術(shù)前組織病理學(xué)正確診斷6例,其診斷符合率為67%。結(jié)論:MSCT不僅能顯示骶尾部惡性生殖細(xì)胞瘤原發(fā)灶的特征,亦能顯示不同器官上轉(zhuǎn)移灶的特點(diǎn),結(jié)合血清AFP明顯升高不難做出定性診斷;MSCT可以補(bǔ)充并完善病理組織學(xué)對(duì)骶尾部惡性生殖細(xì)胞瘤診斷的不足。
[Abstract]:Objective: to evaluate the value of MSCT in the diagnosis of sacrococcygeal malignant germ cell tumor in children. Methods: the MSCT findings of 9 cases of sacrococcygeal malignant germ cell tumor confirmed by imaging, clinic and pathology were analyzed retrospectively. The pathological and clinical features of 9 children were as follows: male 5 cases, female 4 cases, age 5 months and age 4 years, median age 16 months 9 cases with elevated serum AFP, 8 cases with significant increase of serum AFP were detected by MSCT enhancement before operation, and according to the MSCT manifestations of the tumor. According to the Altman classification system, the size, morphology, density, blood circulation, metastasis and serum AFP value were analyzed. There were 5 cases of type 鈪，

本文編號(hào)：1511002