小儿纵隔肿瘤的CT影像和临床分析

摘要

目的 研究小儿纵隔肿瘤的CT诊断特征和临床特点.方法 15例小儿纵隔肿瘤,其中神经母细胞瘤5例,神经节细胞瘤3例,神经鞘瘤1例,胸腺瘤及畸胎瘤各2例,淋巴管瘤和内胚窦瘤各1例.各例于术前、化疗前行胸部CT平扫和增强扫描,3例神经母细胞瘤治疗前、后作尿VMA测定和同步CT扫描.结果 畸胎瘤和胸腺瘤位于前纵隔,神经源性肿瘤和内胚窦瘤发生于后纵隔.神经母细胞瘤呈浸润性生长、钙化、坏死及骨质破坏多见,胸腺瘤有包膜,实质型畸胎瘤常见脂肪和钙化.结论 CT能反映小儿纵隔肿瘤的发生部位、组织与生长特征,易于定性诊断及定期随访观察疗效.%Objective To study clinical presentations and CT features of mediastinal tumours in children.Methods Fifteen children with mediastinal turnouts were studied retrospectively.There were neuroblastoma(NS,5),ganglioneuroma(3),Schwannoma(1),thymoma(2),teratoma(2),lymphangioma(1)and endodermal sinus tumour(EDST 1).CT scans with and without contrast were performed before and after operations or chemotherapy.Results Thymomas and teratomas tended to be located in the anterior mediastinum,whereas neurogenic tumours and EDST predispesed to the posterior mediastinum.Thymorna had capsules.Fat and calcification were commonly okserved in the teratoma.Infiltration.bony destruction,necrosis and calcification were characteristic of NB(the urine VMA of three patients with NB failed to respond to chemotherapy despite shrinkage in size).Conclusions CT scans are accurate in the diagnosis and follow-up of pediatric mediastinal tumours.CT scan is superior to urinal VMA levels in assessing tumour response to chemotherapy.