Ditchfield M R, De Campo J F, Waters K D, Nolan T M
Department of Radiology, Royal Childrens Hospital, Melbourne, Australia.
Med Pediatr Oncol. 1995 Feb;24(2):93-6. doi: 10.1002/mpo.2950240206.
To determine whether a preoperative imaging protocol relying predominantly on a chest X-ray film (CXR) and ultrasound in patients with Wilms' tumor is adequate for patient management and to determine the frequency more sophisticated imaging, in particular, computed tomography (CT), is required.
Historical cohort study at a tertiary pediatric hospital.
60 consecutive patients with Wilms' tumor treated at our institution between 1980 and 1990.
The preoperative imaging was recorded and 2- and 4-year survival were compared with the National Wilms' Tumor Study.
100% of patients had a preoperative CXR, 95% abdominal ultrasound, 5% abdominal CT, 13% chest CT, 47% abdominal X-ray, 2% aortography, 5% cavography, and 35% intravenous urography. The overall 2- and 4-year survivals of 92% and 90%, respectively, did not statistically differ from the National Wilms' Tumor Study 2- and 4-year survivals of 94% and 91%.
A preoperative imaging protocol relying predominantly on a CXR and abdominal ultrasound does not reduce survival. Other more sophisticated imaging, in particular, CT, is not required in the majority of cases and is warranted only when a CXR or ultrasound is unable to resolve relevant management problems.
确定在肾母细胞瘤患者中，以胸部X线片（CXR）和超声为主的术前影像学检查方案是否足以用于患者管理，并确定需要更复杂影像学检查（尤其是计算机断层扫描（CT））的频率。
在一家三级儿科医院进行的历史性队列研究。
1980年至1990年间在我院接受治疗的60例连续肾母细胞瘤患者。
记录术前影像学检查情况，并将2年和4年生存率与国家肾母细胞瘤研究进行比较。
100%的患者进行了术前CXR检查，95%进行了腹部超声检查，5%进行了腹部CT检查，13%进行了胸部CT检查，47%进行了腹部X线检查，2%进行了主动脉造影，5%进行了腔静脉造影，35%进行了静脉肾盂造影。总体2年和4年生存率分别为92%和90%，与国家肾母细胞瘤研究中2年和4年生存率94%和91%相比，差异无统计学意义。
以CXR和腹部超声为主的术前影像学检查方案不会降低生存率。在大多数情况下，不需要其他更复杂的影像学检查，特别是CT，只有在CXR或超声无法解决相关管理问题时才需要进行。
