多中心性尿路移行细胞癌的螺旋CT诊断及评价

目的探讨螺旋CT扫描对多中心性尿路移行细胞癌（TCC）的诊断价值及临床应用评价。方法对12例经临床病理证实的多中心性TCC的CT表现、特点进行回顾性分析，所有病例均进行了三维重建图像，主要是多平面重建及曲面重建。结果肾孟-输尿管5例，肾孟-膀胱2例，输尿管-膀胱3例，肾孟-输尿管-膀胱2例；术前螺旋CT对11例多中心性TCC做出正确诊断，诊断符合率93％。结论螺旋CT扫描及三维重建对多中心性TCC的诊断、鉴别诊断和肿瘤分期有较高的准确性，能明确病变范围、肿块与周围组织的关系，受肾功能影响小，病灶显示直观、全面，可为临床制定治疗方案提供依据。

THE SPIRAL CT DIAGNOSIS AND EVALUATION OF MULTICENTRIC URINARY TRANSITIONAL CELL CARCINOMA

Objective To investigate the diagnosis value and clinical application evaluation of spiral CT scanning in multicentric transitional cell carcinoma（TCC）. Methods The CT findings of 12 patients with multicentric TCC confimed by clinical and pathology were retrospectively reviewed. All patients underwent with plain CT 3D restitution image, mainly is multi planar reconstruction and surface reconstruction. Results The renal pelvis - ureter TCC is 5 patients, the renal pelvis - bladder TCC is 2 patients, the ureter - bladder TCC is 3 patients, renal pelvis - ureter -bladder TCC 2 patients; 93% patients（11/12） with multicentric TCC were identified with CT preoperatively. Conclusion Spiral CT scanning and 3D restitution have higher accuracy to multicentric TCC the diagnosis, differential diagnosis and tumor staging, it can explicit the relation of pathological changes range, mass and surrounding tissues and it had little influence on renal function, the focus display visual and comprehensive, provide evidence for the clinical establishment of treatment protoccls.