螺旋CT在膀胱肿瘤中的临床应用价值

目的探讨螺旋CT在膀胱肿瘤中的临床应用价值。方法应用螺旋CT对28例经纤维膀胱镜(FC)和病理证实膀胱肿瘤的患者做膀胱平扫及四期增强扫描,并对排泄期图像做多平面重组(MPR)、三维(3D)重建和CT仿真膀胱镜(CTVC)成像。采用盲法与FC及手术结果对照分析。结果螺旋CT轴位、3D和CTVC图像对膀胱癌的检出率分别为92.3％、76.9％和96.2％;CT对肿瘤术前分期的准确性为83.0％。轴位图像能很好地显示肿瘤的侵袭深度;MPR可更直观地观察肿瘤的起源、向周围侵犯的情况及其与输尿管的关系;3D和CTVC均能清楚显示肿瘤的大体形态及其与输尿管开口的关系,CTVC有利于显示<5 mm的肿瘤。结论螺旋CT轴位结合MPR、3D和CTVC图像可以为诊断和治疗膀胱肿瘤提供依据。

Value of helical CT in bladder tumor

Objective To evaluate the diagnostic effect of helical CT on bladder tumor. Methods In 28 patients with bladder tumors which had been confirmed by conventional fiberoptic cystoscopy(FC) and pathology, precontrast and four-phase postcontrast helical CT scans were performed with multiple plane reconstruction (MPR) , three dimensional (3D) reconstruction and CT virtual cystoscopy (CTVC) images constructed from the volumetric data of the excretory phase. The results were then compared with the findings of conventional fiberoptic cystoscopy and surgery through a double-blind manner. Results The sensitivity of the helical CT axial, 3D and CTVC images in detecting bladder tumor were 92.3% , 76.9% and 96.2% respectively. The accuracy in preoperative tumor staging of helical CT was 83.0%. The axial images could provide excellent intramural and extravesical information, and MPR could directly show the origin and extravesical invasion of the tumor and its relation to the ureter. 3D and CTVC images were useful in displaying the surface morphology of the tumor and its relation with the ureteric orifices, whereas CTVC images could depict a tumor smaller than 5 mm that could not be visualized on the axial images. Conclusion Combining interpretation of axial, MPR, 3D and CTVC images, helical CT is able to provide comprehensive information for the diagnosis and treatment of bladder tumor.