原发性输尿管肿瘤的临床影像学诊断(九例报告及文献复习)

Clinical Image Diagnosis of Primary Ureteric Tumors:A Report of 9 cases

目的 评价原发性输尿管肿瘤的影像学检查方法并讨论其影像学诊断和鉴别。方法 经手术、病理证实的9例患者均做腹平片 (KUB)、静脉尿路造影 (IVU)及B超 ;7例做逆行尿路造影 (RU) ;2例做肾穿造影 ;3例做CT ;2例做MR。结果 良性肿瘤 4例 (3例带蒂 ) ,其中息肉 3例 ,移行上皮乳头状瘤 1例。均伴有尿路结石。恶性肿瘤 5例 ,其中移行上皮癌 4例、腺癌 1例。 7例RU显示杯口状、圆形、卵园形及条状或静脉曲张样充盈缺损。结论RU及肾穿刺造影为最佳检查方法。条状或静脉曲张样充盈缺损是良性肿瘤的特征 ;扁圆钝状或边缘不规则的截断状梗阻常为恶性肿瘤 ;杯口状、圆形或卵圆形充盈缺损良、恶性肿瘤均可见 ,其充盈缺损边缘不光整时多见于恶性肿瘤。MR尿路成像有望成为最佳方法之一。

Objective To evaluate the image methods for the diagnosis of the primary ureteric tumors.Methods Nine patients with primary ureteric tumors pathologically confirmed were reviewed, All of them were examined by KUB、IVU and B-Ultrasound. Seven cases were examined by retrograde urography(RU).Two cases were examined by percutaneous antegrade pyelography.Three cases were examined with CT and 2 cases with MRI.Results There were 4 cases with benign tumor(among them 3 cases with peduncle)including 3 cases with polyp,1 case with transitional-cell papilloma.All of them were associated with stones. There were 5 cases with malignant tumor including 4 cases transitional-cell carcinoma and 1 case adenocarcinoma.RU in 7 cases showed cupped、round、oval、striped or varicoid defect.Conclusion RU and perculaneous antesrade pyelography are the optimal methods to figure the contour of tumors in ureter.Striped or varicoid defect are the features of benign tumors.The complete obstruction with round-blumt or irregulett-broken frequently suggested the evidence of malignant tumors.Cupped、round or oval defect are seen both benign and malignant tumor.It is malignant features that the margin of the fill defect appears inrregular.MRU provides one of the optimal imaging techgiques.