Hugosson C, Nyman R, Jorulf H, McDonald P, Rifai A, Kofide A, Jacobsson B
Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Acta Radiol. 1999 Sep;40(5):534-42. doi: 10.3109/02841859909175580.
The aims of the study were: 1) to assess the efficacy of different imaging methods for use prior to treatment; 2) to compare the surgico-histopathologically-based International Neuroblastoma Staging System (INSS) staging with the imaging results; and 3) to suggest a localisation scheme for abdominal neuroblastoma.
Thirty-one children with an abdominal neuroblastoma (median age 2 years), underwent abdominal US, CT of chest and abdomen, MR imaging of abdomen and spine, chest radiography, skeletal survey, radionuclide bone scintigraphy, MIBG scintigraphy, and bone marrow biopsy.
In the evaluation of local disease, CT and MR were superior to US. There was no significant difference between CT and MR in assessment of the location or size of the tumour. Evaluation of invasive growth and lymphadenopathy was uncertain irrespective of imaging modality. Intraspinal extension was more distinctly demonstrated with MR. Tissue characterization with CT and MR did not contribute in the assessment of the tumours. Contrast enhancement at CT and MR examinations both improved demarcation between tumour and kidney, and was a necessity for evaluation of vessel encasement with CT. The local disease was best assessed by either CT or MR, while metastatic disease was best revealed by CT, MR, scintigraphy or bone marrow biopsy.
Imaging may be a valuable basis for clinical assessment and pretreatment staging of abdominal neuroblastoma.
本研究的目的为：1）评估治疗前不同成像方法的有效性；2）将基于手术组织病理学的国际神经母细胞瘤分期系统（INSS）分期与成像结果进行比较；3）提出腹部神经母细胞瘤的定位方案。
31例腹部神经母细胞瘤患儿（中位年龄2岁）接受了腹部超声、胸部和腹部CT、腹部和脊柱磁共振成像、胸部X线摄影、骨骼检查、放射性核素骨闪烁显像、间碘苄胍闪烁显像及骨髓活检。
在局部疾病评估中，CT和磁共振成像优于超声。在肿瘤位置或大小评估方面，CT和磁共振成像之间无显著差异。无论采用何种成像方式，对浸润性生长和淋巴结病的评估都不明确。磁共振成像能更清晰地显示脊髓内扩展情况。CT和磁共振成像的组织特征对肿瘤评估无帮助。CT和磁共振成像检查中的对比增强均改善了肿瘤与肾脏之间的界限划分，且是CT评估血管包绕情况的必要条件。局部疾病最好通过CT或磁共振成像进行评估，而转移性疾病最好通过CT、磁共振成像、闪烁显像或骨髓活检来发现。
成像可能是腹部神经母细胞瘤临床评估和治疗前分期的重要依据。
