Colour Doppler ultrasound assessment of the inferior vena cava in patientswith Wilms' tumour

OBJECTIVE: To assess the diagnostic accuracy of colour flow Doppler ultraso und in diagnosing inferior vena caval (IVC) extension of tumour thrombus in patients with Wilms' tumour. MATERIALS AND METHODS: Over a 3-year period from June 1994 to June 1997, 74 patients with Wilms' tumour were referred to our institution. In this retr ospective study we reviewed the preoperative colour flow Doppler ultrasound reports of 64 of these patients and compared the reports with the intra-op erative findings in 51 patients who underwent surgery. RESULTS: Vena caval extension of tumour thrombus was present in 12 patients (18.7 %) and in six of these patients (9.4 %) there was also atrial extens ion of the tumour. Colour flow Doppler ultrasound correctly diagnosed IVC e xtension of tumour thrombus in nine patients and correctly predicted the cr anial extent of the tumour thrombus in eight patients. CONCLUSION: Colour flow Doppler ultrasound has an overall positive predicti ve value of 73.4 % in assessing IVC patency and correctly diagnosing IVC ex tension of tumour thrombus, in patients with Wilms' tumour. However, non-di agnostic ultrasound examinations can occur in over 20 % of patients. (C) 19 99 The Royal College of Radiologists.