Wootton-Gorges S L, Albano E A, Riggs J M, Ihrke H, Rumack C M, Strain J D
The Children's Hospital, and the University of Colorado Health Sciences Center, Department of Radiology, Denver 80218, USA.
Pediatr Radiol. 2000 Aug;30(8):533-7; discussion 537-9. doi: 10.1007/s002470000204.
Determination of the presence of pulmonary metastases in children with Wilms' tumor is an important part of staging and treatment. We sought to compare the efficacy of chest radiography (CXR) and chest CT in the evaluation for pulmonary metastases in patients with Wilms' tumor.
This retrospective study included 83 children with Wilms' tumor diagnosed between 1980 and 1993. All patients with pulmonary nodules (n = 12) as well as 14 Wilms' tumor patients without pulmonary metastases (control group) had blinded review of the CXR and chest CTs by three pediatric radiologists. Presence, size, and certainty of metastatic diagnosis were recorded. Medical records were reviewed. The remaining 57 patients had review of their medical and imaging records to confirm the absence of pulmonary metastases.
Ten of the 12 with pulmonary masses had imaging available for review. Eight had both positive CXR and chest CT examinations. Two patients had pulmonary nodules seen by CT only: one had a right cardiophrenic angle mass and died as a result of liver metastases. The other had a solitary nodule, which proved to be a plasma-cell granuloma. Overall, the CXR and chest CT data concur in 79/81 (98%).
CXR alone appears adequate for the diagnosis or exclusion of pulmonary metastases in patients with Wilms' tumor.
确定肾母细胞瘤患儿是否存在肺转移是分期和治疗的重要部分。我们试图比较胸部X线摄影（CXR）和胸部CT在评估肾母细胞瘤患者肺转移方面的疗效。
这项回顾性研究纳入了1980年至1993年间诊断的83例肾母细胞瘤患儿。所有有肺结节的患者（n = 12）以及14例无肺转移的肾母细胞瘤患者（对照组）的胸部X线片和胸部CT均由三位儿科放射科医生进行盲法评估。记录转移诊断的存在、大小和确定性。查阅病历。其余57例患者的医疗和影像记录被查阅以确认无肺转移。
12例有肺部肿块的患者中有10例有可供评估的影像资料。8例胸部X线片和胸部CT检查均为阳性。2例患者仅CT发现肺结节：1例右心膈角肿块，死于肝转移。另1例为孤立结节，后来证实是浆细胞肉芽肿。总体而言，胸部X线片和胸部CT数据在81例中有79例一致（98%）。
对于肾母细胞瘤患者，仅胸部X线摄影似乎足以诊断或排除肺转移。
