Total-body opacification in the diagnosis of Wilms's tumor and neuroblastoma. A note of caution.

Abstract

O'connor and Neuhauser in 1963 described a method of total-body opacification with relatively large doses of intravenously injected radiopaque contrast medium (3). The injected medium mixes with the blood and is uniformly distributed throughout the blood vascular compartment in less than sixty seconds. The added density of the various body tissues is proportional to the blood supply. An avascular or hypovascular lesion will acquire a radiolucency in contrast to adjacent structures with greater blood supply which contain blood mixed with the radiopaque contrast medium. The total-body opacification effect can be produced best in infancy but requires excellent radiographic technic. It is particularly useful in defining cystic, hemorrhagic, and necrotic lesions (2). Although the originators of the technic recognized the limitation of the method in differentiating necrotic or poorly vascularized neoplasms from cysts, others have suggested that the demonstration of an absolutely avascular renal mass in infancy ...