影像学检查对肿瘤所致上尿路梗阻的诊断价值

THE VALUE OF DIAGDOSING UPPER URINARY TRACT TUMOUR CAUSED OBSTRUCTIVE DISEASES

目的:探讨数字化X线摄影尿路造影、螺旋CT(SCT)、磁共振成像(MRI+MRU)对上尿路肿瘤所致梗阻的诊断价值。方法:对28例上尿路肿瘤病例进行影像学检查分析,比较不同检查方法的诊断准确率。结果:尿路造影对上尿路肿瘤所致梗阻定位、定性及梗阻与扩张程度诊断的准确率分别为93 %、93 %、100 %;SCT诊断的准确率分别为90 %、90 %、80 %;MRI+ MRU诊断的准确率分别为85.7 %、71.4 %、71.4 %。结论:尿路造影为上尿路肿瘤首选且有重要价值的检查方法,对多数肿瘤的部位、形态、病变范围及病因可作出明确诊断。SCT可作出明确的定性及分期诊断,对手术可切除性作术前评估,为选择手术方式提供依据。MRI+ MRU可显示更多软组织病变信息,指导临床治疗方案的选择实施。

Objective: To approach the value of Digital Radiography Urography(including IVU, RU, PAP) SCT and MRI+MRU in diagnosing upper urinary tract tumour caused obstructive diseases. Methods: 28 cases taken imageology examination by digital radiography urography with SCT and MRI+MRU were studied in determining the obstructive location and evaluating the degree of obstruction. Results: The accuracy of digital radiography urography in determining the obstructive location, nature and degree of upper urinary tract tumour reaches 93 %, 93 % and 100 %; SCT reaches 90 %, 90 % and 80 %; MRI+MRU 85.7 %, 71.4 % and 71.4 %. Conclusion: Urography is a very important mean and can make clear diagnosis for the location, morphology, pathology range and cause of most tumors. SCT can make not only a explicit diagnosis for the nature and different period but also an evaluation about excising before operation and provide a basis for the way in operation. MRI+MRU can depict abundant information of soft pathology to direct the surgical therapy.