MSCT对小儿骶尾部恶性生殖细胞瘤的诊断价值

发布时间：2018-02-14 15:20

  本文关键词： 儿童 骶尾部 生殖细胞瘤 恶性 体层摄影术 螺旋计算机　出处：《放射学实践》2015年02期 　论文类型：期刊论文

【摘要】：目的:评估MSCT对小儿骶尾部恶性生殖细胞瘤的诊断价值。方法:回顾性分析9例经影像临床及病理证实的小儿骶尾部恶性生殖细胞瘤的MSCT表现、病理学及临床特征。9例患儿中男5例,女4例,年龄5个月~4岁,中位年龄16个月。9例血清AFP均升高,明显升高者(300ng/mL)8例(8/9)。所有患儿术前均行MSCT增强检查,并根据肿瘤的MSCT表现,按照Altman分型系统进行分类,分析其大小、形态、密度、血运、转移情况及血清AFP值。结果:本组9例患儿中Ⅱ型1例,Ⅲ型3例,Ⅳ型5例。肿瘤均较大(42mm×43mm~132mm×21mm),实性肿瘤居多(5/9)。肿瘤密度不均匀,无脂肪成分或仅含有点状脂肪成分肿瘤7例,9例肿瘤均可见丰富血运,增强后呈不均匀明显强化,且均可见局部浸润或远处器官转移,其中骶骨及椎体骨破坏最常见(8/9);其次为下腔静脉或髂静脉瘤栓(6/9);亦可见肝、肺转移及椎管浸润等。术前CT正确诊断8例(8/9),其诊断符合率为89%;术前组织病理学正确诊断6例,其诊断符合率为67%。结论:MSCT不仅能显示骶尾部恶性生殖细胞瘤原发灶的特征,亦能显示不同器官上转移灶的特点,结合血清AFP明显升高不难做出定性诊断;MSCT可以补充并完善病理组织学对骶尾部恶性生殖细胞瘤诊断的不足。
[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，

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