Liu Yuqing,Xiang Yonghua,Li Li,et al.Multi-slice spiral computed tomography features and differential diagnosis of different pathological sub- types of hepatoblastoma[J].Journal of Clinical Pediatric Surgery,,21():452-457.[doi:10.3760/cma.j.cn101785-202111046-010]
Multi-slice spiral computed tomography features and differential diagnosis of different pathological sub- types of hepatoblastoma
- Keywords:
- Hepatoblastoma/DI; Hepatoblastoma/CL; Tomography; X-ray computed
- Abstract:
- Objective To explore the multi-slice spiral computed tomography (MSCT) features and dif- ferential diagnosis of different pathological subtypes of hepatoblastoma (HB). Methods Imaging and clinical data were retrospectively reviewed for 71 HB children confirmed by surgery or puncture biopsy. According to the pathological results, they were divided into fetal, embryonal and mixed epithelial & mesenchymal types. CT ima- ges were observed from whether tumor margin was regular, exogenous, PRETEXT staging, multiple nodule fu- sion, intratumoral hemorrhage, necrosis or cyst, calcification, neoplastic envelope was smooth and continuous, whether capsule retraction, subcapsule effusion, multiple fiber separation and high-risk image characteristics. Tumor size and CT value of solid components of each phase were measured. Chi-square or Fisher’s exact test was utilized for comparing differences in gender, age, alpha-fetoprotein (AFP) and focal morphological charac- teristics. Independent sample analysis of variance was employed for comparing differences in tumor size and CT values among three groups. Results Statistically significant differences existed in tumor maximum diameter, regular margins, multiple nodules, hemorrhage, necrosis or cystic degeneration, calcification, multiple fibrous separation and capsule retraction among different pathological subtypes (P < 0. 05). Fetal type had the CT features of small tumor diameter, regular margin and more uniform intratumoral density; embryonal type features more multifocal nodules, necrosis or cystic degeneration;mixed epithelial and mesenchymal type was associated with a high rate of intratumoral hemorrhage and calcification and a high incidence of delayed multiple fibrous separation and capsule retraction. During portal phase, absolute embryonal enhancement was less than that of fe- tal or mixed epithelial & mesenchymal type (P < 0. 05). Conclusion Different pathological subtypes of HB have different CT signs with their own characteristics. And CT imaging can distinguish the pathological subtypes of HB to a certain extent.
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Memo
收稿日期:2021-11-21。
基金项目:湖南省科技厅临床医疗技术创新引导计划项目（S2020SFYLJS0680）
通讯作者:金科,Email:jinke001@sina.com