Brasch R C, Randel S B, Gould R G
AJR Am J Roentgenol. 1981 Nov;137(5):1005-9. doi: 10.2214/ajr.137.5.1005.
In a retrospective review, computed tomography (CT) was compared to a "routine" combination of other diagnostic imaging procedures used for follow-up evaluations of 13 children being treated for Wilms tumor. The examined variables were diagnostic accuracy, expense, and duration of examination. Results from 13 patients indicated that CT most accurately answers diagnostic queries pertinent to follow-up evaluation of Wilms tumor: the presence and extent of bilateral renal tumors, local recurrence, contralateral renal hypertrophy, and metastasis to liver or lungs, For diagnosing pulmonary metastases, CT was superior to conventional chest radiography both in sensitivity (4/4 vs. 2/4) and specificity (9/9 vs. 6/9). In depiction of liver metastases, CT (3/3) was superior to liver scintigraphy (2/3). The extent of bilateral Wilms tumors was better defined by CT than by urography. In no instances were the alternative diagnostic imaging studies found to be more accurate than CT for detection of recurrent tumor. Average cost for a CT examination ($344) is considerably less than the cost for a routine combination of the other imaging studies ($594). Examination time and diagnostic radiation does are also reduced using CT. Pending larger comparison studies, CT is recommended as the primary diagnostic method for follow-up evaluation of patients with Wilms tumor.
在一项回顾性研究中，对13例接受肾母细胞瘤治疗的儿童进行随访评估时，将计算机断层扫描（CT）与其他诊断性成像程序的“常规”组合进行了比较。所检查的变量包括诊断准确性、费用和检查时长。13例患者的结果表明，CT最能准确回答与肾母细胞瘤随访评估相关的诊断问题：双侧肾肿瘤的存在和范围、局部复发、对侧肾肥大以及肝或肺转移。对于诊断肺转移，CT在敏感性（4/4对2/4）和特异性（9/9对6/9）方面均优于传统胸部X线摄影。在显示肝转移方面，CT（3/3）优于肝脏闪烁扫描（2/3）。CT比尿路造影能更好地确定双侧肾母细胞瘤的范围。在检测复发性肿瘤方面，未发现其他诊断性成像研究比CT更准确。CT检查的平均费用（344美元）远低于其他成像研究常规组合的费用（594美元）。使用CT还可减少检查时间和诊断性辐射剂量。在进行更大规模的比较研究之前，建议将CT作为肾母细胞瘤患者随访评估的主要诊断方法。
