Rohrschneider W K, Weirich A, Rieden K, Darge K, Tröger J, Graf N
Department of Pediatric Radiology, University of Heidelberg, Im Neuenheimer Feld 153, D-69 120 Heidelberg, Germany.
Pediatr Radiol. 1998 Jun;28(6):435-43. doi: 10.1007/s002470050378.
To describe the imaging features of nephroblastomatosis with US, CT and MR, to point out characteristics of differentiation between nephrogenic rests (NR) and Wilms' tumour (WT) and to determine the most appropriate imaging modality.
We reviewed the US, CT and MR images of 29 cases of histopathologically confirmed nephroblastomatosis sent to our department for reference evaluation (German nephroblastoma study). The series included 17 kidneys with NR, 6 kidneys with WT and 32 kidneys with both NR and WT.
NR presented as multinodular, peripheral, cortical lesions, the diffuse form of distribution being less common. Foci were homogeneous and of low echogenicity, density or signal intensity. The lesions were most clearly depicted with contrast-enhanced CT and T1-weighted (T1-W) MR images. Lesions smaller than 1 cm were rarely identified by US. The most reliable criterion to differentiate NR from WT was their homogeneity.
Contrast-enhanced CT and T1-W MR images are of similar potential and superior to US in the diagnosis of nephroblastomatosis. Due to the significant radiation dose of serial CT, MR imaging should be the method of choice wherever it is available. The cost-effectiveness and availability of US makes it ideal for serial follow-up of known lesions.
描述肾母细胞瘤病的超声、CT及MR成像特征，指出肾源性残留（NR）与肾母细胞瘤（WT）的鉴别特点，并确定最合适的成像方式。
我们回顾了29例经组织病理学证实的肾母细胞瘤病的超声、CT及MR图像，这些病例被送至我科以供参考评估（德国肾母细胞瘤研究）。该系列包括17个有NR的肾脏、6个有WT的肾脏以及32个既有NR又有WT的肾脏。
NR表现为多结节状、周边性皮质病变，弥漫性分布较少见。病灶均匀，回声、密度或信号强度低。增强CT及T1加权（T1-W）MR图像能最清晰地显示病变。小于1cm的病灶很少能被超声发现。区分NR与WT最可靠的标准是其均匀性。
增强CT及T1-W MR图像在肾母细胞瘤病的诊断中具有相似的潜力且优于超声。由于系列CT的辐射剂量较大，只要有条件，MR成像应作为首选方法。超声的成本效益及可及性使其成为已知病变系列随访的理想选择。
