肾盂移行上皮细胞癌影像诊断价值比较研究

目的：探讨4种检查方法在肾盂移行上皮细胞癌诊断中的价值。方法：对经手术病理证实的32例肾盂移行上皮细胞癌,术前经IVP、超声、MRI、螺旋CT检查,分析其敏感性。结果：静脉肾盂造影21例中直接诊断肾盂移行上皮细胞癌8例,可疑肾盂移行上皮细胞癌3例,占52.4%。超声检查20例中直接诊断肾盂移行上皮细胞癌8例,发现肾窦分离提示肾盂移行上皮细胞癌可能5例,占65.0%。MRI检查21例中直接诊断肾盂移行上皮细胞癌13例,提示肾盂移行上皮细胞癌可能5例,占85.7%。螺旋CT检查28例中直接诊断肾盂移行上皮细胞癌19例,提示肾盂移行上皮细胞癌可能6例,占89.3%。增强19例中11例轻度不均匀强化,6例均匀强化,2例无明显强化。结论：肾盂移行上皮细胞癌的生长位置主要影响静脉肾盂造影的诊断,肿瘤的生长方式是主要影响超声的诊断。无论在肾盂移行上皮细胞癌癌灶的发现还是定性方面,螺旋CT和MRI的敏感性和诊断价值优于超声和静脉肾盂造影,CT与MRI无明显差异。

Comparative study of imagings in transitional cell carcinoma of the renal pelvis

Objective：The value of four methods in the diagnosis of transitional cell carcinoma in the renal pelvis were explored.Methods：32 cases of transitional cell carcinoma in the renal pelvis proved by surgery and pathology.The examinations were performed with IVP,BU,CT and MR before the operation,finally,a sensitivity analysis was performed.Results：The 11 cases was determined and suspected by IVP（52.4%）,the 8 cases were not development,the 2 cases were normal by IVP in 21 cases of transitional cell carcinoma of renal pelvis; The 13 cases was determined and was suspected by diagnosis （65.0%）, 1 case were misdiagnosed as blood clot, the 6 cases were normal by BU in 20 cases; The 18 cases was determined and was suspected （85.7%）, the 3 cases were misdiagnosed as 1 renal cell carcinoma and 1 case of tuberculosis and 1 case of blood clot by MRI 21 cases of transitional cell carcinoma in the renal pelvis; The 25 cases was determined and was suspected ie. 89.3%, the 3 cases were misdiagnosed, as 1 case of tuberculosis and 1 papilloma of the renal pelvis and 1 case of blood clot by CT in 28 cases. 11 cases of slightly enhancement uneven and 6 cases enhancement even and 2 cases no enhancement of the tumor on cortex stage, there was no significant change in the parenchymal phase and renal plvis ptrase of compared with cortex stage in the contrast-enhanced. Conclusion：The main effect of growth position of renal pelvis tumor in VIP, the main effect of growth mode of renal pelvis tumor in BU, both complementarity obvioaly. Whether on transitional cells carcinoma of renal pelvis, has heigher diagnostic sensitivity and accuracy of the CT and MRI than IVP and BU in transitional cells carcinoma of renal pelvis, there is no significantly difference between CT and MRI in transitional cells carcinoma of renal pelvis.