Keywords:
Paediatric, Oncology, Kidney, Ultrasound, Ultrasound-Spectral Doppler, Ultrasound-Colour Doppler, Arterial access, Haemodynamics / Flow dynamics
Authors:
I. Begun; Minsk Region/BY
DOI:
10.1594/ecr2013/C-1160
Results
According to our data the volume of the affected organ for nephroblastoma was correlated with blood flow in its main artery (r = 0,45; p <0,05).
This dependence characterized by inefficient circulation of the affected kidney,
and probably reflects the need for change in the absolute amount of blood flow in tumor growth,
though the specific blood supply of healthy organs were much higher than that of the affected (p = 0,00001).
Specific indices of blood supply of the affected and contralateral kidneys were 1.32 (1,04-2,13) ml / cm ³ / min and 5.46 (3,73-6,78) ml / cm ³ / min,
respectively.
These results are agreement with the known fact - a healthy kidney is one of the organs that best supplied with blood (renal fraction of cardiac output is 20-25%).
Thus,
absolute blood flow volume to the main renal artery of affected kidneys in children with nephroblastoma was increased relatively unaffected side (p = 0.00003),
which was not observed in children with neuroblastoma in the adrenal gland (Fig.
2) of comparable tumor volume (252 (143-420) ml and 202 (50-270) ml (p = 0.07)) and of similar sonographic characteristics of these tumors (Fig.
3,
4).
Percentage changing of blood flow volume (%Q) in the main renal artery of the affected kidney (relatively to the unaffected side) as a diagnostic criterion was used (Fig.
5). The problem of choosing the threshold (cut-off value) %Q values and of evaluating the diagnostic efficiency for its use has been solved with the help of the mathematical apparatus of the ROC-analysis [3]. Relative index (% Q) as a diagnostic criterion was much better indicator of the absolute values of blood flow in the main renal artery (Q) on the affected side,
that can be seen by comparing the characteristic curves (Fig.
6).
In the diagnosis of nephroblastoma by increased blood flow for affected kidneys (threshold of the 20%; decision rule: parameter > threshold ) the sensitivity and specificity in the differential diagnosis with adrenal neuroblastoma were 83% and 100% respectively.