输尿管恶性肿瘤的影像学诊断

目的：探讨输尿管恶性肿瘤的影像学表现，提高对该病的诊断水平。方法：选择过去5年经手术和病理证实的12例输尿管恶性肿瘤患者，回顾性分析其静脉尿路造影、US、CT和MRI表现，并与手术及病理结果进行对照。结果：CT与MRI准确地检出了所有12例肿瘤，对其向周围组织的浸润范围和腹腔淋巴结肿大也作了正确的判断。静脉尿路造影仅显示3例输尿管狭窄或梗阻，6例患侧尿路未见显影或显影不佳。尽管US检出了所有12例肿瘤所致的尿路积水，但仅2例诊断为输尿管肿瘤，4例提示输尿管狭窄。结论：CT和MRI对诊断输尿管恶性肿瘤有很高的敏感性，并能对其准确分期。尿路造影和US对肿瘤所致的输尿管狭窄和梗阻有一定的诊断价值，但通常不能直接显示肿瘤及其向周围组织的浸润。

Imaging diagnosis of ureter malignant tumors

Objective:To analyze the imaging features of ureteral malignant tumor and improve the imaging diagnostic ability of this disease.Methods:Twelve patients with ureteral malignant tumor confirmed by surgery and histopathology over the past five years were selected as the object of this study.Their examination results of intravenous urography (IVU),ultrasonography (US),computed tomography (CT) and magnetic resonance imaging (MRI) were analyzed retrospectively.Results:CT and MRI detected accurately all 12 cases tumors.The periureteral invasion,lymphadenopathy,and distant metastases were correctly identified by CT and MRI in these patienta.IVP showed only 3 patients with ureteral stricture or obstruction.The lesion-sided urinary tract wasn't opacified or only was indistinctly opacified in 6 patients with this technique.Although US detected hydronephrosis and hydroureter in all 12 cases tumors,only 2 patients were positively diagnosed with ureteral tumor and 4 cases were indicated ureteral stricture.Conclusion:CT and MRI appear to have a high diagnostic sensitivity and staging accuracy in ureteral malignant tumors.Although IVU and US can efficiently detect the hydronephrosis and hydroureter resulted in by tumors,both techniques seems to be unreliable in showing the mass itselfe and its local invasion.