The role of triplex Doppler ultrasongraphy in diagnosis of malign abdominal tumors on infants

Introduction: In the last years in pediatric oncology, big progresses have been made, also in therapy as in diagnostics. To obtain a good evolution in a malign process on a child, it is very important to diagnose it in a early stage. If present a tumor formation at a 1–6 months old child, the chances are at 50% that the tumor is malignant. The access to ultrasonography, CT, MRI, scintigraphy and biopsy is very important to make a diagnose correctly and quick.

Materials and methods: We report a period of 5 years with 25 cases childs of abdominal tumors witch has been proven to be malignant. The type of this tumors was: 6 nefroblastoms, 5 neuroblastoms, 3 hepatoblastoms, 3 hepatocelular carcinoma, 3 nonhodgkin lymphomas, 2 rabdomiosarcoms, 2 liver metastases, 1 angyosarcoma Kaposi. As an initial diagnostic method the ultrasongraphy was the principal investigation technique and this proves it's importance for screenings in paediatry. Transducers of 3.5, 5 and 7.5MHz where used. Color Doppler technique with contrast enhancing substance (Magnevist) was also used. The minimum size of a detectable tumor formation was between 0.3–0.5cm.

Results and discussion: If the abdominal tumor is solid, there is a suspicion of an malign tumor and than CT and MRI are imperious necessary. The ultrasongraphy can exclude a cyst formation from a solid tumor or other abdominal lesions. The Wilms tumor (nefroblastoma) is the most encountered neoformation in childhood. It represents 9% of all child's neoformations and 90% of all renal infants tumors. The neuroblastoma is an embryo tumor and it's representing 7–10% of all child's neoformations. The ultrasound aspect of hepatoblastoma and hepatocarcinoma is identical. The first is most common at the age of max 3 years and the second after this time period. In lymphomas the ultrasound examinations can reveal the presence of intraabdominal adenopathy, hepatomegaly, and important splenomegaly. All malign abdominal tumors on infants have an accentuated vascular neodesign revealed by the triplex Doppler technique.

Conclusions: The ultrasonographic found of a tumor forces us to analyze and describe the following semiolgical signs: location, number, dimension, consistence, echogenity, echostructure, invasions and delimitation. Doppler Triplex proves to be a very efficient method with a high value in diagnosis of vascular anomalies of neoformations and it certifies in most cases the malign invasion.