多层螺旋CT三维成像在肾盂输尿管癌诊断中的应用价值

Three-dimensional spiral CT in the diagnosis of renal pelvic and ureteral carcinoma

目的探讨多层螺旋CT三维成像技术（3D-MSCT）在肾盂输尿管癌诊断中的应用价值。方法对73例上尿路肿瘤患者进行3D-MSCT检查，结果与手术病理结果进行比较。男53例，女20例。年龄48-78岁，平均63岁。其中肾盂癌44例，输尿管癌29例。结果3D-MSCT诊断肾盂癌44例，重建图像表现为肾盂或肾盏内软组织密度影，肾盂或肾盏腔内偏心性充盈缺损；输尿管癌28例，可疑输尿管占位病变1例，曲面重建（CPR）图像表现为输尿管管腔内软组织影，管腔内充盈缺损、管腔偏心狭窄或闭塞，上方输尿管不同程度扩张。肿瘤大小0．5cmx0．5cm～5．8cm×6．0cm。结论3D-MSCT可对肾盂输尿管癌进行直观立体观察，受肾功能影响小，是诊断肾盂输尿管癌有价值的方法。

Objective To assess the diagnostic value of three-dimensional spiral CT（3D-MSCT） in renal pelvic and ureteral carcinoma. Methods Seventy-three patients with upper urinary tract carcinoma including 44 renal pelvic carcinomas and 29 ureteral carcinomas were reviewed in this study. There were 53 male and 20 female, and patients age ranged from 48 to 78 （average age 63） years. All patients underwent 3D-MSCT examination before operation, and the results of radiography were compared with operation foundings and pathological results. Results The 3D-MSCT examinations revealed 44 cases of renal pelvic carcinoma, which showed as soft tissue density and filling defect in renal pelvic or calices. The 3D-MSCT examinations revealed 28 cases of ureteral carcinoma and one case of suspicious ureteral occupation, which showed as soft tissue density, filling defect, lumina decentre stenosis or obstruction in ureter and dilated upper urinary tract. The tumor＇s diameters ranged from 0.5 cm to 6.0 cm. All the 73 cases were confirmed to be transitional cell carcinoma by surgical findings and pathological results. Conclusions 3D-MSCT is a useful imaging modality for detecting renal pelvic and ureteral carcinoma.