CT与MRI诊断小儿肾肿瘤腹部分期的比较研究——来自三级保健中心医院的报告

Debarpita Datta, Debashis Dakshit, N. Basu, R. Bansal
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摘要

目的:比较CT与MRI对小儿肾肿瘤局部分期的诊断价值。材料和方法:研究人群来自我们医院加尔各答医学院和医院。采用CT和MRI进行基线腹部成像。在2020年10月至2021年11月为期一年的研究期间,对50例肾肿瘤病例进行了回顾性审查,并计划进行肾切除术。评估每个病例的囊膜穿透、淋巴结转移、肿瘤血栓、术前肿瘤破裂和对侧同步病变。手术和病理结果为参考金标准。结果:CT和MRI检测包膜穿透的灵敏度分别为70%和60% (P=0.73),特异性分别为84.3%和84% (P=1.0)。CT和MRI检测淋巴结转移的敏感性分别为80%和53% (P=0.22),特异性分别为88%和92% (P=1.0)。5/12例CT及8/12例MRI发现对侧病变。结论:CT与MRI对淋巴结转移及囊膜穿透的诊断价值相近。MRI对侧同步病变的检测更为准确;然而,这些都是在极少数情况下观察到的。因此,任何一种方式都可以用于小儿肾肿瘤的初始局部-区域分期
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A Comparative Study of Diagnostic Performance of CT and MRI for Abdominal Staging of Paediatric Renal Tumours-A Report from Tertiary Care Centre Hospital
Objective: To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumours. Materials and Methods: The study population was derived from our hospital Medical College Kolkata and Hospital. Baseline abdominal imaging performed with both CT and MRI.A retrospective review was done with 50 renal tumour cases selected and planned for nephrectomy over a study period of one year from October 2020 to November 2021. Each case was evaluated for capsular penetration, lymph node metastasis, tumour thrombus, preoperative tumour rupture, and synchronous contralateral lesions. The surgical and pathological findings were the reference gold standard. Results: The sensitivity of CT and MRI for detecting capsular penetration was 70% and 60%, respectively (P=0.73), while specificity was 84.3% and 84% (P=1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 80% and 53% (P=0.22), and specificity was 88% and 92% (P=1.0). Synchronous contralateral lesions were identified by CT in 5/12 cases and by MRI in 8/12 cases. Conclusion: CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MRI was more accurate in detecting contralateral synchronous lesions; how-ever these were observed in a very a smaller number of cases. Hence either modality can be used for initial loco–regional staging of paediatric renal tumours
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