Grundzüge der MRT-Diagnostik einschließlich Ganzkörper-Bildgebung in der pädiatrischen Onkologie

Zusammenfassung

Die MRT stellt für die meisten malignen Tumoren im Kindesalter die entscheidende Bildgebung für das lokoregionäre Staging dar. Die Erfassung der lokalen Tumorausbreitung sowie die Gewebecharakterisierung müssen umfassend erfolgen. Daher sind an die kindliche Anatomie adaptierte Untersuchungsprotokolle, die sich an Leitlinien der onkologischen Gesellschaften orientieren, essentiell. Da einige Tumorentitäten wie z. B. das Nephroblastom in bestimmten Altersgruppen initial ohne bioptische Sicherung mit Chemotherapie behandelt werden, sind die Kenntnisse der vielfältigen Differenzialdiagnosen notwendig. Die hochaufgelöste GK-MRT erfasst in einer Untersuchung sowohl die lokale als auch die systemische Ausbreitung, sodass multiple Teilkörperuntersuchungen eingespart werden können. Die technischen Voraussetzungen, einige Untersuchungsstrategien sowie die klinische Bedeutung typischer Befunde der lokalen und der systemischen MRT-Bildgebung im Kontext zu nuklearmedizinischen Methoden werden in dieser Übersicht besprochen.

Abstract

MRI is the modality of choice for local staging in most solid pediatric malignancies. Following guidelines of pediatric oncologic societies, tumor volume, infiltration and tissue characterization have to be throughly evaluated using examination protocols adapted to and optimized for pediatric patients. Because certain tumor entities (e. g. nephroblastoma) are treated initially with­out histological proof, in a specific age group, knowledge of the various differential diagnoses is crucial. Using highly resolved whole-body MRI both, local and systemic tumor burden can be assessed resulting in a reduction of multiple regional examinations. In this review the principle techniques and examination strategies of whole body MRI as well as the clinical relevance of characteristic findings will be discussed, also with respect to methods of nuclear medicine.

Schlüsselwörter

pädiatrische Onkologie - solide Tumoren - pädiatrische MRT - Ganzkörper-MRT - Nuklearmedizin - PET - PET/MRT

Key words

pediatric oncology - solid tumor - pediatric MRI - whole-body MRI - nuclear medicine - PET - PET/MRI

• Literatur

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