先天性中胚层肾瘤的CT影像学特征及其与超声、组织病理学特征的对照分析

CT imaging characteristics of congenital mesoblastic nephroma and their comparison with ultrasound and histopathological features

    摘要
  • 摘要:
    目的 探讨先天性中胚层肾瘤（CMN）的CT影像学特征，并将其与超声、组织病理学特征进行对照，探究其组织病理学基础。
    方法 回顾性分析2008年1月至2017年7月就诊于中山大学附属第一医院经组织病理学检查确诊的10例CMN患儿的临床资料和影像学资料，其中男患儿8例、女患儿2例，年龄1个月~7岁（12.6±26.1）个月；细胞型CMN 2例、经典型CMN 6例、以经典型成分为主（>80%）的混合型CMN 2例。分析CMN患儿CT平扫和增强扫描的影像学特点，并将经典型CMN及以经典型成分为主（>80%）的混合型CMN的CT影像学特征与超声、组织病理学特征进行对照。
    结果 经典型CMN及以经典型成分为主（>80%）的混合型CMN的CT影像学特征多表现为类圆形的实性（3/8）或囊实性（5/8）肿物，且边界欠清（8/8）；肿瘤实性部分密度不均（7/8），增强扫描后不均匀强化（8/8）；与细胞型CMN相比，肿瘤内肾盂（8/8）及增强扫描后出现特征性“双边征”（7/8）是其特殊的影像学特征。组织病理学检查结果显示，CT影像学特征中的“双边征”与超声图像中的低回声环相对应，是由肿瘤周围扩张的血窦所致的特殊影像学征象。
    结论 “双边征”及肿瘤内肾盂为经典型CMN及以经典型成分为主的混合型CMN的CT影像学特征。

     

    Abstract:
    Objective To investigate the CT imaging characteristics of congenital mesoblastic nephroma (CMN) and compare them with ultrasound and histopathological features to explore the histopathological basis of CMN.
    Methods Clinical and imaging data of 10 children with CMN confirmed by histopathology in the First Affiliated Hospital, Sun Yat-sen University from January 2008 to July 2017 were retrospectively analyzed. The cohort included 8 males and 2 females, aged from 1 month to 7 years ((12.6±26.1) months). Two cases of cellular CMN, 6 cases of typical CMN, and 2 cases of mixed CMN mainly with typical components (>80%) were evaluated. The characteristics of plain and contrast-enhanced CT scans of the children with CMN were summarized, and the CT characteristics of typical CMN and mixed CMN mainly with typical components (>80%) were compared with ultrasound and histopathological features.
    Results CT imaging characteristics of typical CMN and mixed CMN mainly with typical components (>80%) were as follows: mostly round solid (3/8) or cystic solid (5/8) masses with poorly defined boundaries (8/8); uneven density of the solid part of the tumor (7/8); and uneven enhancement (8/8). Compared with cellular CMN, intratumoral renal pelvis (8/8) and bilateral sign (7/8) after enhanced scan were the special imaging features. Histopathological results showed that the bilateral sign in the CT imaging characteristics corresponded to the hypoechoic ring signal in ultrasound images, which is a special imaging sign caused by the dilated blood sinus around the tumor.
    Conclusion Bilateral sign and intratumoral renal pelvis were the CT imaging characteristics of typical CMN and mixed CMN mainly with typical components.

     

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