肾盂输尿管移行细胞癌的螺旋CT诊断

目的 评价螺旋CT扫描及三维重建技术对肾盂输尿管移行细胞癌的诊断与鉴别诊断以及临床意义。资料与方法 对27例经临床证实的肾盂输尿管移行细胞癌CT表现、特点进行回顾性分析，所有病例均常规进行平扫，肾皮质期、实质期及排泄期增强扫描，并进行多平面重建（MPR）、曲面重建（CMPR）及容积重建（VR）、最大密度投影（MIP）和仿真内镜（VE）等重组及三维重建。结果 术前CT对25例肾盂输尿管移行上皮癌做出正确诊断。诊断准确率92．59％，对肿瘤分期准确率84％。三维重建有助于明确病变范围、肿块与周围组织的关系，使得病灶形态显示更为全面和直观。结论 螺旋CT扫描及三维重建对于肾盂输尿管移行上皮癌的诊断、鉴别诊断和肿瘤分期有较高的准确性，可为临床制订治疗方案提供依据。

The Spiral CT Diagnosis of Transitional Cell Carcinoma of Renal Pelvis and Ureter

Objective To evaluate the clinical value of spiral computed tomography with 3D reconstruction for diagnosis and differential diagnosis of transitional cell carcinoma of renal pelvis and ureter.Materials and Methods The CT findings of 27 patients with transitional cell carcinoma of renal pelvis and ureter confirmed by clinic were retrospectively reviewed. All patients were underwent with plain CT scanning; dual phase enhanced scanning and CT urography. The various 3D reconstruction(MPR,CMPR,VR,MIP VE) methods were used. Results 92.59% patients (25/27) with transitional cell carcinoma of renal pelvis and ureter were identified with CT preoperatively; 84% of tumors were accurately staged. The various 3D reconstruction were helpful to depict relation with lesions and its surrounding structure.Conclusion Spiral CT with 3D reconstruction has higher diagnostic accuracy for diagnosis and differential diagnosis of transitional cell carcinoma of renal pelvis and ureter, it could provide reliable information for treatment planning.