Role of Computed Tomography in the Evaluation of Pediatric Retroperitoneal Masses: A Retrospective Study

Abstract

Objective: Retroperitoneum is one of the largest spaces in the body. Retroperitoneal (RP) masses are common in paediatric age group and present with vague clinical features. Computed Tomography (CT) is an excellent imaging modality in the evaluation of RP masses. The aim of this study was to evaluate the role of CT in the detection and characterization of RP masses. Materials and Methods: 28 clinically suspected or sonographically detected RP masses formed the material of the study. Detailed clinical history was elicited from the patients/attendants and findings of general physical examination recorded. Non-contrast and Contrast Enhanced CT was performed and masses were evaluated with respect to site of origin, consistency, components and pattern of enhancement. Probable CT diagnosis was made and findings correlated with pathological/laboratory findings wherever possible. The results were subjected to statistical analysis and expressed as percentages and proportions.Results: Majority of patients were seen in 1-5 years age group with M:F ratio of 1.8:1. Lump abdomen was the commonest presenting feature followed by pain abdomen. Lymph nodal masses were the commonest primary RP space mass while renal masses accounted for the majority of secondary RP masses in our study. Pathological/Laboratory correlation was available in 21 cases and CT was able to differentiate benign and malignant lesions in 95.2% cases. Overall diagnostic accuracy of CT in the evaluation of RP masses was 85.7%. Conclusions: CT is a simple and reliable tool in diagnosing pediatric RP masses with a high diagnostic accuracy.

A spectrum of findings on computed tomography in paediatric abdominal and pelvic tumours in a Ghanaian teaching hospital

“…In evaluating retroperitoneal masses with a CT scan, a study by Vikrant et al found the diagnostic accuracy of CT scan to be 85.7 %. 6 Factors such as the late presentation of many of our cases, evidenced by the large tumour size at presentation leading to uncertainty in the primary organ of origin, particularly in neuroblastoma and nephroblastoma cases, may have been a limiting factor. In addition, the lack of a standardized protocol for CT studies from other imaging facilities may have contributed to the relatively lower accuracy for those tumours.…”

“…Fortunately, newer multi-detector CT models boast of lower radiation dose techniques/algorithms and shorter scan times. 6 On the other hand, Magnetic Resonance Imaging provides superb soft tissue resolution and is ideal for evaluating the Central Nervous System. However, it is more expensive and less available; it has long image acquisition times with the need for longer periods of specialized sedation than required for CT scans.…”