Department of Imaging, Kaifeng Children’s Hospita
目的 探讨增强 CT 在儿童肾透明细胞肉瘤（CCSK）与肾母细胞瘤（WT）鉴别诊断中的临床价值。方法 选60 例疑似 CCSK/WT 患儿均进行增强 CT、病理学检查，对比 2 项检验结果，并分析增强 CT 的检查征象。结果 经病理切片免疫组织化学染色法诊断，CCSK 患儿有 23 例（38.33%），均为单侧发病，左侧 17 例，右侧 6 例，瘤体昀大径 5.26～15.62cm，未发现转移病灶；WT 患儿有 37 例（61.67%），均为单侧发病，左侧 21 例，右侧 16 例，瘤体昀大径 7.14～20.14cm，未发现转移病灶。根据增强 CT 结果总结出 5 个重要征象（即钙化灶、瘤内出血灶、坏死或囊变、肿块边缘小囊征 CCSK、WT），它们之间对比无差异（P＞0.05），虎斑样条纹征在 WT 中的占比高于在 CCSK 中的占比（P＜0.05）。结论 增强 CT 在诊断鉴别儿童 CCSK 与 WT 时，具有显著的临床价值，有利于疾病的确诊和及早治疗。
Objective To investigate the clinical value of enhanced CT in the differential diagnosis of renal hyaluronsarcoma (CCSK) and nephroblastoma (WT) in children. Methods 60 suspected CCSK/WT children were admitted in our hospital. All the children were examined by enhanced CT and pathology. The results of the two tests were compared and the signs of enhanced CT were analyzed. Results 23 cases (38.33%) were diagnosed as CCSK by immunohistochemical staining of pathological sections, all of them had unilateral disease, 17 cases were on the left side and 6 cases were on the right side, the maximum diameter of the tumor was 5.26～15.62cm, and no metastatic lesions were found. There were 37 cases (61.67%) of WT, all of them had unilateral disease, 21 cases on the left side and 16 cases on the right side, the maximum diameter of the tumor was 7.14～20.14cm, and no metastatic lesions were found. According to the results of enhanced CT, five important signs of diagnosis were summarized.Among them, calcification, intratumoral hemorrhage, necrosis or cystic degeneration, and small cyst at the edge of the mass showed no difference between CCSK and WT (P>0.05). The proportion of upper CCSK was higher than that of WT (P<0.05). Conclusion Enhanced CT has significant clinical value in the diagnosis and differentiation of CCSK and WT in children, which is helpful for the diagnosis and early treatment of the disease.
陈巧菊.增强 CT 鉴别诊断儿童肾透明细胞肉瘤与 肾母细胞瘤的临床价值[J].生物医学工程学进展,2023,(2):188-191复制