输尿管癌的螺旋CT评价

目的:探讨螺旋CT在评价输尿管癌中的临床应用价值.方法:应用螺旋CT对32例经临床和病理证实输尿管癌的患者做平扫及4期增强扫描,并作多平面重组(MPR)和CT尿路成像(SCTU),观察螺旋CT各种成像方法诊断病变的能力,并与其他检查技术及手术病理结果进行比较.结果:32例输尿管癌中31例诊断正确,假阴性1例、假阳性2例.螺旋CT上肿瘤可分为3型:管壁增厚型、腔内肿块型和腔外肿块型;多期轴面结合MPR能很好地显示肿瘤的数目、部位、大小、形态、侵犯范围、与邻近结构的关系及尿路梗阻的情况,曲面MPR更为直观;29例手术患者输尿管病变在螺旋CT图像上的表现与手术所见有很好的一致性.SCTU可获得类似于X线尿路造影的图像,能立体显示肿瘤的状况.螺旋CT有利于患者术后的随访.结论:螺旋CT多期扫描结合曲面MPR及SCTU图像能较完整、准确地提供输尿管癌多方位、全面的资料,弥补其他影像学检查的不足,具有很高的临床应用价值.

Helical CT Evaluation of the Ureteral Carcinoma

Objective:To evaluate the clinical applications of helical CT scans in the ureteral carcinoma.Methods:The precontrast and four-phase postcontrast helical CT scans were performed in 32 patients with ureteral carcinoma confirmed by clinic and pathology,and the multiplanar reformation (MPR) and spiral CT urography (SCTU) images were generated from the volumetric data.The ability of helical CT in detecting and diagnosing of ureteral carcinoma was investigated.The results were then compared with the findings of the other imaging techniques and surgery.Results:31 of 32 ureteral carcinomas were correctly diagnosed using helical CT,with false negative 1 case and false positive 2 cases.On helical CT images,he tumors had three distinct patterns:ureteral wall thickening,intraluminal mass and extraluminal mass.Combined with multiple-phase axial and MPR images,the number,location,size,morphology,extension,the relationship with surrounding structures,and the urinary obstruction of the tumor could be clearly demonstrated,and the curved MPR was useful in directly detecting the tumors.The findings of ureteral lesion on helical CT images corresponded well with that of surgery in 29 cases.SCTU could produce a three-dimensional image that mimics conventional urography,and was useful in displaying the ureteral carcinoma from multiple views.Helical CT was also useful in evaluating the postoperative fellow-up of the ureteral carcinoma.Conclusion:Combined with the multiple-phase axial images,curved MPR and SCTU images,helical CT can perfectly provide multi-orientation and comprehensive information of ureteral carcinoma,compensate the some disadvantages of the other imaging techniques,and is playing an important role in clinical diagnosis and therapy.