脐尿管癌的CT诊断

Diagnosis and differential diagnosis of urachal carcinoma by computed tomography

目的探讨脐尿管癌的CT表现特点。方法回顾性分析经病理证实的18例脐尿管癌及炎性病变患者的临床资料和CT表现。结果脐尿管癌15例，脐尿管炎性病变3例。所有患者的病变部位均在腹中线Retzius间隙脐尿管走行区，其中17例位于脐尿管膀胱交界区的膀胱顶壁或前壁，1例位于脐尿管上端。15例脐尿管癌cT扫描时呈囊实性（11例）或实性（4例）；6例可见病灶中心或周边点状、斑点状或弧形钙化。3例脐尿管炎性病变中，1例为囊肿伴感染，表现为厚壁囊性肿块；2例为慢性炎性肉芽肿，表现为软组织肿块；3例炎性病灶周同脂肪间隙均呈明显炎性反应，可见较多斑片、条索影。结论脐尿管癌的CT表现具有特征性，CT扫描能提供较为准确的定位和定性诊断信息。

Objective To analyze CT imaging characteristics of urachal carcinoma. Methods CT findings of 18 pathologically proven urachal masses were retrospectively reviewed. Results Of these 18 cases, 15 were urachal carcinomas, while 3 were inflammatory masses. All 18 masses were situated in the midline of the Retzius space along the course of the urachus, and 17 of those in the juxtavesical portion of the urachus, and only 1 close to the umbilical end. The urachal carcinomas presented as mixed cystic-solid lesions（ n = 11 ） or completely solid masses （ n = 4 ）. Calcification was radiologically visible in 6 cases, and presented as punctate, stippled, or curvilinear in the peripheral or central area of the lesions. Of the 3 inflammatory lesions, 1 infected urachal cyst looked like a thlck-walled cystic lesion, 2 chronic inflammatory granulomas manifested as irregular soft tissue masses, and apparently infiltrated into the surrounding adipose tissue. Conclusion Urachal carcinoma has its own characteristics on the CT image, which is helpful in diagnosis.