B超、CT和静脉肾盂造影诊断肾母细胞瘤的价值

Evaluation of ultrasonogram, CT, and intravenous pyelography in diagnosis of Wilms tumor

目的:比较B超、CT和IVP诊断肾母细胞瘤的价值。方法:肾母细胞瘤98例,年龄3个月～9岁,中位年龄2.5岁,98例均行B超检查,50例行CT检查,89例行静脉肾盂造影(IVP)。比较3种方法的检查结果并与术中所见及病理检查结果进行对照分析。结果:B超、CT及IVP诊断肾母细胞瘤的符合率分别为93.8％(92/98),88.0％(44/50)和78.0％(70/89)。常见误诊原因是把肾母细胞瘤误诊为肾外肿物,手术和病理检查发现被误诊的肿瘤常位 于肾上极或肾下极。B超联合CT或IVP均能显著提高肾母细胞瘤的诊断符合率(98％与97％)。结论:3种影像学 检查诊断肾母细胞瘤均有一定的误诊率。B超操作灵活,诊断符合率高,应为诊断小儿肾母细胞瘤的首选方法。

Aim: To compare diagnostic accuracy of ultrasonogram, computer tomography (CT) and intravenous pye-lography (IVP) in evaluation of Wilms tumor. Methods: Ultrasonogram, CT and IVP were performed in 98 cases (3 months -9 years old, average 2.5 years old, with Wilm's tumor. The diagnosis from ultrasonogram, CT and IVP was compared each other and with what found during operation and pathological examination. Results: The method with highest diagnostic accuracy was ultrasonography accounting to 93. 8% (92/98) , then were CT and IVP accounting to 88% (44/50) , and 78% (70/89) , respectively. Wilms tumors, which located at upper and lower pole of kidney, were common misdiag-nosed as non-kidney tumor. Conclusion: Ultrasonogram had a high diagnostic value for pediatric patients with renal tumor which should be the first choice to be used to evaluate the WT.