视网膜母细胞瘤（RB）是3岁以下儿童最常见的恶性肿瘤，具有较高的致残率和死亡率。本研究的目的首先是评估多模态成像在儿童 RB 鉴别诊断和预测选择性眼动脉输注 (SOAI) 疗效方面的临床疗效，其次是确定与该疗效相关的因素。研究回顾性收集了 256 名单侧 RB 且眼内受累儿童的数据，包括多模态成像磁共振成像 (MRI)、计算机断层扫描 (CT) 和临床特征。其中33例同时具备CT和MRI数据，以组织病理学结果作为金标准评价区分RB的诊断准确性。另外，对256例眼内受累的单侧RB患者SOAI治疗前的MRI及临床特征进行回顾性分析。分析影像学特征和临床特征对儿童治疗效果的预测能力，评估不同肿瘤分期的眼球挽救率和视力保留差异。CT影像对RB的诊断准确率为96.96%，而MRI检查准确率为84.84%，两者与组织病理学结果一致性较高。 CT 图像显示后部眼内肿块，具有高密度外观，肿瘤内可见斑点、斑块或簇状钙化。 CT值大多在100 Hounsfield单位（HU）以上，增强扫描可见非钙化肿块有不同程度的强化。 MRI 在 T1 加权图像上显示低或中等信号强度，在 T2 加权图像上显示中到高信号强度，给予造影剂后显着增强。钙化较多的肿瘤显示长T1和短T2信号。预后较好的患者具有较高的δ信号增加（ΔSI）、距视盘的距离较大、肿瘤直径较小、无植入结节或植入范围较小、内源性生长模式、视网膜脱离程度较小、不存在临床高危险因素，无玻璃体出血，无眼球缩小，钙化体积较小。肿瘤与视盘之间的距离、临床高危因素和肿瘤生长模式被发现是与预后相关的独立因素。随着肿瘤分期的增加，眼球抢救成功率和视力下降。CT和MRI对于小儿RB肿瘤的综合评估具有很高的价值。仅MRI就可以完成对RB患者的全面评估，从而可以减少儿童的辐射剂量。肿瘤钙化对于诊断至关重要，影像学检查结果可以为患者预后和治疗计划提供信息。肿瘤与视盘的距离、临床高危因素、肿瘤生长方式等与儿童预后密切相关。2024转化儿科。版权所有。

Retinoblastoma (RB) is the most common malignant tumor in children under the age of 3 years and is associated with a high disability and mortality rate. The aim of this study was, first, to evaluate the clinical efficacy of multimodal imaging in differentially diagnosing RB in children and in predicting the efficacy of selective ophthalmic artery infusion (SOAI) and, second, to identify the factors associated with this efficacy.This study retrospectively collected the data from 256 children with unilateral RB and intraocular involvement, including multimodal imaging magnetic resonance imaging (MRI), computed tomography (CT), and clinical characteristics. Among the cases, 33 with both CT and MRI data available were used to evaluate the diagnostic accuracy in distinguishing RB, with histopathological results serving as the gold standard. Additionally, a retrospective analysis was conducted on the MRI and clinical characteristics of 256 cases of unilateral RB with intraocular involvement before SOAI treatment. The predictive ability of imaging features and clinical characteristics for the treatment efficacy of children was analyzed, and the differences in globe salvage rates and visual preservation based on different tumor stages were evaluated.The diagnostic accuracy of CT imaging for RB was 96.96% while that of MRI was 84.84%, with both showing high consistency with the histopathological results. CT images demonstrated a posterior intraocular mass with a high-density appearance, with spots, patches, or clustered calcifications visible within the tumor. The CT values were mostly above 100 Hounsfield units (HU), and enhanced scanning showed varying degrees of enhancement in noncalcified masses. MRI showed low or moderate signal intensity on T1-weighted images and moderate-to-high signal intensity on T2-weighted images, with significant enhancement after contrast administration. Tumors with more calcifications showed long T1 and short T2 signals. Patients with better prognosis had a higher delta signal increase (ΔSI), a greater distance from the optic disc, smaller tumor diameter, absence of implantation nodules or smaller implantation range, endogenous growth pattern, smaller extent of retinal detachment, absence of clinical high-risk factors, no vitreous hemorrhage, no globe shrinkage, and smaller calcification volume. The distance between the tumor and optic disc, clinical high-risk factors, and tumor growth pattern were found to be independent factors associated with prognosis. The rate of successful globe salvage and visual acuity decreased with increasing tumor stage.CT and MRI are highly valuable for the comprehensive assessment of tumors in pediatric RB. MRI alone can complete a comprehensive assessment of patients with RB and thus allow for the reduction radiation dose in children. Calcification of the tumor is crucial for diagnosis, and imaging findings can serve to inform patient prognosis and treatment planning. The distance between the tumor and optic disc, clinical high-risk factors, and tumor growth pattern are closely related to the prognosis of children.2024 Translational Pediatrics. All rights reserved.