16层螺旋CT诊断单侧上尿路多发癌

目的 探讨16层螺旋CT扫描对单侧上尿路多发癌的诊断价值.方法 回顾性分析10例经病理证实的单侧上尿路多发癌患者的16层螺旋CT影像表现.结果 单侧肾盂、输尿管多发癌同时累及膀胱6例,肾盂及输尿管同时受累3例,输尿管中下段癌累及膀胱1例.CT图像上表现为病变肾盂及输尿管管壁不规则增厚和(或)腔内软组织肿块,管腔变窄,累及膀胱者表现为膀胱壁不规则增厚或软组织肿块,大范围的曲面重建可全程清晰显示上尿路病变累及范围,直观显示上尿路腔内外改变.发现腹膜后淋巴结肿大3例,2例经病理证实为转移癌,影像所见与手术、病理完全符合.结论 16层螺旋CT容积扫描能清楚显示单侧上尿路多发癌发生的部位、累及范围.

Diagnosis of multiple carcinomas in the unilateral upper urinary system with 16-slice spiral CT

Objective To assess the clinical value of 16-slice spiral CT in the diagnosis of multiple carcinomas in unilateral upper urinary system. Methods The imaging findings of 16-slice spiral CT of 10 patients suffered from multiple carcinomas in the unilateral upper urinary system proven pathologically were analyzed. Results Among 10 cases, 6 cases had multiple carcinomas in the unilateral renal pelvis and ureter and simultaneously involved urinary bladder, 3 cases had the multiple carcinomas in the unilateral renal pelvis and ureter, and 1 case had the multiple carcinomas in the lower and middle ureter and involved urinary bladder. CT images clearly presented the thickened irregular renipelvic and ureteric wall with stenosis and/or mass in the renipelvic and ureteric cavity. The urinary bladders involved by carcinoma were depicted as thickened irregular wall of urinary bladder or the mass in the wall of urinary bladder. The images of curved reconstruction clearly showed the extention of the multiple carcinomas and the changes of the urinary tract involved by the multiple carcinomas. Enlarged retroabdominal lymph nodes were detected in 3 cases simultaneously, and 2 of them were proved metastasis, the imaging findings were absolutely identical to that of the operation and pathological examination. Conclusion Sixteen slice spiral CT can clearly and accurately depict the location and extention of multiple carcinomas in the unilateral upper urinary system.