双源CTA及尿路成像对于输尿管癌诊断的临床应用价值

目的探讨双源cT增强及尿路戍像在输尿管癌诊断中的临床应用价值。方法对于30例拟诊断输尿管癌的患者行cTA及尿路成像重建，cTA后处理技术包括多平面重建（MPR）、最大密度投影（MIP）和容积重建（VRT）等。结朵确诊17例输尿管癌病变，肿瘤位于右侧输尿管9例，位于左侧输尿管的8例；输尿管上段5例，中段5例，下段7例；管壁不规则增厚，管腔弥漫性狭窄3例，管腔偏心性肿块2例，输尿管呈软组织密度影，管腔消失12例：突入膀胱内2例。增强方式，肿块明显强化15例，轻度强化1例，输尿管壁明显强化1例。间接征象，肿块近端及肾盂呈现不同程度积水，周围侵犯及淋巴结肿大，肾盂输尿管延迟显影。结论双源cT增强扫描及尿路成像能够多平面、多方位显示肿瘤，再结合轴位动态增强图像，对于输尿管癌的诊断有极高的应用价值。

Clinical Application of Dual-sorce CTA and Urography in Diagnosing Primary Ureteral Carcinoma

Objective To evaluate the value of dual-sore CT angiography in diagnosing Primary Ureteral Carcinoma, Materials and Methods 30 patients who suspected as Ure- teral Carcinoma were underwent both CTA and Urography, 3D postprocessing techniques included MPR MIP and VRT. Results In our series, Primary Ureteral Carcinoma were ｜bund in 17 of the 30 patients. 9 cases were detected in right ureter and 8 cases were in left ureter, 5 cases were in the superior ureter, 5 in midpiece, 7 in inferior segment. Ureteral wall thickening were found in all the Ureteral Carcinoma, diffuse lumens stenosis were 3, eccen- tric lumens mass were 2. 15 cases were hypervascular and hyperattenuating on arterial phase scans and 1 was hypoattenuating, Ureteral wall enriching was 1. indirect sign were founded ,such as hydronephrosis, lymphadenectasis and delaying of pelvis and ureter. Conclusion Dual-sorce CTA and Urography with advanced image processing is a powerful tool that utilized to identify the imaging features of Primary Ureteral Carcinoma including the presence of muti-plane ,muff-position and muti-stage enhancement.