原发性输尿管移行细胞癌的影像学诊断 (附32例报告)

目的　提高原发性输尿管移行细胞癌的诊断水平。方法　回顾性分析32例原发性输尿管移行细胞癌的临床特点及诊断。结果 本组32例，男性19例，女性13例。临床表现有肉眼血尿者24例(86.8%)，血尿伴腰痛10例(31.3%)，仅表现为腰痛5例(15.6%)，腹部包块2例(6.3%)。B超检查发现输尿管实质占位病变9例(28.1%)。静脉尿路造影(IVU)30例，4例(13.3%)发现典型的输尿管腔内充盈缺损。26例逆行尿路造影，诊断20例(77.0%)。CT扫描13例，11例(84.6%)发现输尿管内肿块影。磁共振泌尿系成像(MRU)7例，诊断输尿管癌5例(71.4%)。结论　密切结合临床表现，综合应用各种检查手段，是提高原发性输尿管癌的术前诊断率的关键。

The imaging diagnosis of primary ureteral transitional cell carcinoma ( Report of 32 cases)

Objective　To improve the diagnosis of primary ureteral transitional cell carcinoma. Methods The clinical characteristic and diagnosis were analysed retrospectively in 32 cases of primary ureteral transitional cell carcinoma. Results The patients consisted of 19 males and 13 females.Among the 32 cases，24(75.0%) had symptoms of gross hematuria，10(31.3%)had hematuria concomitant with flank pain，5(15.6%) had sole flank pain，abdominal mass had been palpated in 2 (6.3%). 9(28.1%) were definitely diagnosed out of 32 by B-ultrasound，4(13.3%) out of 38 by IVU，20(77.0%) out of 26 by retrograde urography，11(84.6%) out of 13 by CT，5(71.4%) out of 7 by MRU.Conclusions The rational application of these methods with attention to symptoms and signs were keys to improve accuracy of diagnosis.【Key words】ureteral carcinoma；imaging； diagnosis