ROLE OF MULTIDETECTOR COMPUTED TOMOGRAPHY IN EVALUATION OF PEDIATRIC ABDOMINAL TUMORS

CORRESPONDING AUTHOR:
Dr. Rashmi M. Nagaraju,
Nagambika Nilaya,
# 86, Shivapura, Srirampura Post,
Manandavadi Road,
Mysore-570008,
Karnataka, India.
E-mail: rashmi83nagaraj@gmail.com

ABSTRACT: BACKGROUND: A wide variety of tumors may affect pediatric abdomen, which arise from various organs. These may be benign or malignant. OBJECTIVES: (1) To assess the role of computed tomography in the evaluation of pediatric abdominal tumors- in localization and characterization. (2) To illustrate the common pediatric abdominal masses. MATERIALS AND METHODS: 30 patients in the age group 0 to 18 years with suspected abdominal mass underwent non contrast and contrast enhanced computed tomography. The lesions were evaluated in terms of location, organ of origin, CT characters (Including attenuation, enhancement, Presence of necrosis, cystic changes and calcifications) and extensions. Based on the age of the patient and the CT characters, provisional and differential diagnoses were given. These were correlated with the final diagnosis obtained after surgical and histopathological examination and the sensitivity of CT in locating and characterizing various abdominal masses was calculated. RESULTS: Majority of patients in our study belonged to infantile age group (<1 year). Neuroblastomas were the most common tumor in our study followed by Wilms’ tumor. Based on organ of origin, adrenal was the commonest organ of origin, followed by kidney and liver. Malignant tumors outnumbered benign tumors by 2:1. Multidetector computed tomography was an excellent imaging modality in localizing and characterizing these tumors. It had a diagnostic accuracy of 96.3 % and was 100 % sensitive in detecting calcifications. It thus helped in narrowing differential diagnosis and in most cases helped in providing a provisional diagnosis close to final histopathological diagnosis. It also helped to provide details of extensions and mass effect of these tumors, with local involvements and distant metastases, which in turn were very important in planning further management. CONCLUSIONS: Multidetector computed tomography (MDCT) is a very sensitive imaging modality. It is fast, reliable, significantly accurate method for localizing and characterizing various tumors arising from pediatric abdomen. It helps in narrowing differentials and arriving at a final diagnosis in most cases. It also provides significant information for operative management.

KEYWORDS: pediatric abdominal tumors, multidetector computed tomography, neuroblastoma, Wilms’ tumor.