Zerin J M, Haliloglu M, Cohen M D
Department of Radiology, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis, IN 46209, USA.
Pediatr Radiol. 1996;26(8):547-52. doi: 10.1007/BF01372239.
We reviewed the length of the solitary kidney from all ultrasound examinations in 34 children who had undergone unilateral nephrectomy for Wilms' tumor, in order to determine the frequency of renal hypertrophy in this population. Standard sonographic criteria for nephromegaly were used.
We generated a z-score for each measurement of the renal length, using an interpolated computer model based on published standards for sonographic renal length in relation to age. A retrospective age- and gender-matched control population of children with sonographically normal paired kidneys was generated from a departmental computerized pediatric uroradiology data base, and their ipsilateral renal lengths were compared with those of the study patients. Sonographic renal hypertrophy (SRH) was defined by two or more consecutive measurements of the renal length exceeding two standard deviations longer than the mean for the patient's age, with no later normal measurement.
Seventeen (50 %) of the 34 patients developed SRH. The latest measurements of the solitary kidney in the patients were significantly longer (mean z = 2.210) than in their controls (mean z = 0.040), even among the patients who did not develop SRH (patients' mean z = 1.000, controls' mean z = -0. 210, p < 0.001). Because boys had slightly longer kidneys than girls (both patients and controls), SRH was also noted more often in boys. The frequency of SRH was unrelated to age at nephrectomy, side of the solitary kidney, tumor stage, chemotherapy regimen, or treatment with radiation therapy.
Although renal growth in a solitary kidney is accelerated in most children after unilateral nephrectomy for Wilms' tumor, the sonographic length of the solitary kidney will be larger than normal in only half of the patients.
我们回顾了34例因肾母细胞瘤接受单侧肾切除术的儿童的所有超声检查中孤立肾的长度，以确定该人群中肾肥大的发生率。使用了肾肿大的标准超声标准。
我们使用基于已发表的超声肾长度与年龄关系标准的插值计算机模型，为每次肾长度测量生成一个z分数。从科室计算机化儿科泌尿放射学数据库中生成一个年龄和性别匹配的回顾性对照人群，这些儿童的双侧肾脏超声检查正常，并将他们同侧肾长度与研究患者的进行比较。超声肾肥大（SRH）的定义为肾长度连续两次或更多次测量超过患者年龄平均值的两个标准差以上，且随后无正常测量值。
34例患者中有17例（50%）发生SRH。患者孤立肾的最新测量值明显长于对照组（平均z = 2.210），即使在未发生SRH的患者中也是如此（患者平均z = 1.000，对照组平均z = -0.210，p < 0.001）。因为男孩的肾脏略长于女孩（患者和对照组均如此），所以男孩中SRH的发生率也更高。SRH的发生率与肾切除时的年龄、孤立肾的侧别、肿瘤分期、化疗方案或放疗治疗无关。
虽然大多数因肾母细胞瘤接受单侧肾切除术的儿童孤立肾的生长加速，但只有一半的患者其孤立肾的超声长度会大于正常。
