Radiologic evaluation of surgical resectability in abdominal neuroblastoma

To assess the resectability of abdominal neuroblastoma, three parameters were framed in the lateral view aortogram: AV index, AS index, and AS angle. AV index is the ratio of the maximum distance between the aorta/spinal column and the height of the fourth lumbar vertebral body (HV). AS index is the ratio of the maximum distance between the aorta/superior mesenteric artery (SMA) and the HV. AS angle is the angle between the aorta and SMA. Thirty-four aortograms from 21 patients with abdominal neuroblastoma were reviewed, and these parameters were measured in each of the aortograms. Radical resection of the tumor was achieved in ten of 12 patients (83%) with an AV index less than 0.5; however, radical resection was performed in only three of 12 patients (25%) with an AV index greater than or equal to 0.5. The AV index was less than 0.5 in ten of 13 patients (77%) undergoing radical resection. On the other hand, resection was delayed in all ten patients with an AV index greater than or equal to 0.5. Radical resection was achieved in 12 of 14 patients (86%) when the AS index was less than 1.0, but in only one of ten patients (10%) with an AS index greater than or equal to 1.0. Also, the AS index was less than 1.0 in 12 of 13 patients (92%) with radical resection. However, surgery was postponed in all ten patients with an AS index greater than or equal to 1.0. There appeared to be no significant relation between resectability and AS angle. The AV and AS indexes, which are derived from lateral view aortograms, seem to be useful parameters in assessing the resectability of abdominal neuroblastoma.