Cushing B, Slovis T L
Department of Pediatrics and Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit 48201-2196.
Urol Radiol. 1992;14(4):241-51. doi: 10.1007/BF02926941.
The imaging of Wilms' tumor needs to be quite focused so that the oncologist and surgeon can most precisely stage the patient before operation. The imager needs to be exact about the extent of the primary tumor and define any invasion into the adjacent soft tissues. The ability to detect nodal disease is quite difficult but clearly influences the preoperative approach and staging. Children with large tumors extending across the midline in whom primary resection may lead to tumor spillage are prime candidates for preoperative chemotherapy, and the imager has significant input in making this decision. The imager must define metastases in the lungs and the liver and evaluate the risk of bilateral tumor (particularly metachronous) by searching the index kidney for multifocal lesions or nephroblastomatosis in either kidney.
肾母细胞瘤的成像需要非常有针对性，以便肿瘤学家和外科医生能够在手术前最精确地对患者进行分期。成像人员需要准确了解原发肿瘤的范围，并确定是否侵犯了相邻的软组织。检测淋巴结疾病的能力相当困难，但显然会影响术前的治疗方法和分期。对于肿瘤较大且跨越中线、进行初次切除可能导致肿瘤溢出的儿童，术前化疗是主要选择，成像人员在做出这一决定方面发挥着重要作用。成像人员必须确定肺部和肝脏的转移情况，并通过检查患侧肾脏是否存在多灶性病变或双侧肾母细胞瘤病来评估双侧肿瘤（尤其是异时性肿瘤）的风险。
