儿童囊性部分分化型肾母细胞瘤的影像特征分析及文献复习OA

Objective:To investigate the imaging features of cystic partially differentiated nephroblastoma(CPDN)in chil-dren.Methods:The clinical,pathological,and imaging data of eight pediatric CPDN cases treated at our institution were retrospectively analyzed.Ultrasonography was performed in seven cases;all eight cases underwent non-contrast and contrast-enhanced CT,and two cases underwent non-contrast and contrast-enhanced MRI.The imaging features of CPDN were sum-marized in combination with relevant literature.Results:The cohort included six females and two males,aged 5 months to 3 years(median age:1 year 3 months).Clinical manifestations included abdominal distension,palpable abdominal mass,and hematuria.Seven cases were of the conventional type and classified as Bosniak Ⅲ;one case was of the papillonodular type and classified as Bosniak Ⅳ.The median maximal thickness of the septa was 7.69 mm,with predominantly mild to moder-ate enhancement.In the papillonodular case,the nodular component measured 1.81 cm in maximal diameter and showed mild enhancement.The median maximal diameter of the cystic cavity was 4.14 cm.Cystic fluid appeared anechoic or hypoechoic on ultrasonography,had CT attenuation values ranging from 3.63 to 29.93 HU,and exhibited low or slightly low signal on T1WI and high signal on T2WI.One case was complicated by intracystic hemorrhage and another by left upper calyceal dilatation with hydronephrosis.The tumors were generally composed of multiple septa and cystic spaces.Based on the proportion of well-differentiated tissue within the septa,seven conventional-type cases were classified as grade 1,and the papillonodular case as grade 2.The cyst walls were lined by cuboidal or hobnail epithelium,the septa and nodules con-tained a certain amount of immature renal germ,epithelial tubules or glomeruloid structures,and mesenchymal components.Conclusion:Pediatric CPDN has diverse imaging manifestations with certain characteristic features.Conventional CPDN lacks solid nodules,while papillonodular CPDN is a specific variant.Areas with denser and thicker septa were usually asso-ciated with small cysts,whereas areas with thinner and sparser septa tender to contain large cysts,and the imaging charac-teristics of the cystic fluid reflect differences in its internal composition.