Characteristics analysis of clinicopathology and magnetic resonance imaging of mediastinal neuroblastoma in children / 肿瘤研究与临床

ABSTRACT

Objective To investigate the clinicopathological and magnetic resonance imaging (MRI)characteristics of mediastinal neuroblastoma (NB) in children,and to improve the preoperative diagnosis accuracy of NB.Methods The clinicopathological characteristics and imaging data of 16 patients with pediatric NB confirmed by pathology in Children's Hospital of Chongqing Medical University from January 2012 to December 2016 were retrospectively analyzed,including the onset age,lesion size,shape and boundary of the tumors,and MRI scan,and the characteristics of the enhanced signals,which were compared with the postoperative pathology,then the data were also analyzed.Results The age of onset was from 30 d to 11 years old,with the median age of 1.98 years old;all cases occurred in the posterior mediastinum,including 7 cases in left superior posterior mediastinum,4 cases in right superior posterior mediastinum,3 cases in left posterior mediastinum,1 case in right posterior mediastinum,1 case in right posterior mediastinum,1 case in neck and 2 cases in adrenal area;the maximum diameter of tumor was 3-10 cm,with the average of 6.4 cm;the tumor morphology and boundary10 cases were irregular and 6 cases were regular;I0 cases had multiple nodular fusion,12 cases were lengthwise,12 cases had clear border,1 case had crossing the midline of the tumor,2 cases had multiple tumors,and 15 cases had tumor and spinal canal.MRI signalplain scan T1WI showed low signals in 4 cases,equal signals in 12 cases.Plain scan T2WI showed uniform high signals in 9 cases,mixed high signals in 7 cases;hemorrhagic necrotic cysts of tumors in 11 cases,slight enhancement in 2 cases,moderate enhancement in 5 cases,and strengthened enhancement in 5 cases.Postoperative pathology showed that there were 9 cases of complete capsule and 5 cases of incomplete capsule or without capsule,including,2 cases of surrounding organs invasion;and 7 cases transferred from other parts,including 5 cases of bone metastasis,2 cases of bone marrow,2 cases of lymph nodes,1 case of left lung,and 1 case of bone and soft tissue.The cut surface of the tumors showed gray in 4 cases,grey brown in 6 cases,gray white and brown in 4 cases;hemorrhage in 2 cases,calcification in 2 cases,necrosis in 3 cases,cystic degeneration in 1 case,hemorrhage and necrosis in 2 cases,necrotic calcification in 2 cases,and hemorrhagic calcification in 2 cases.There were 4 cases combined with pleural effusion,and 4 cases combined with pneumonia,4 cases of Horner syndrome,and 1 case of lung consolidation or atelectasis.Conclusion The MRI manifestations of pediatric NB patients have some characteristics.Combination with their clinical characteristics can provide an important basis for the early diagnosis and accurate diagnosis of NB.