多层螺旋CT泌尿系成像在尿路上皮癌患者随访中的临床价值

Clinical value of multi-slice spiral CT urography in the follow-up of patients with previous urothelial cancer

目的评价多层螺旋CT泌尿系成像(multi-slice spiral computed tomography urography,MSCTU)在尿路上皮癌患者随访中的临床价值。方法 2006年1月～2010年7月我科共行2800例MSCTU检查,其中413名尿路上皮癌患者术后随访共行466例MSCTU检查,包括平扫、肾实质期和排泄期三期扫描。顺序注射造影剂100ml(370mgI/ml)和100ml生理盐水,注射速度均为4.5ml/s。对MSCTU轴位及三维后处理图像进行前瞻性诊断,以评价是否有肿瘤复发。分析诊断的敏感性、特异性、准确性、阳性和阴性预测值。参考标准为病理学结果和随访临床资料。结果对尿路上皮癌患者的术后随访中,MSCTU诊断肿瘤复发的敏感性、特异性、准确性、阳性和阴性预测值分别为92.0%、99.0%、97.1%、97.2%和97.1%。结论 MSCTU对随访尿路上皮癌患者肿瘤复发具有重要的临床价值。

Objective To assess the clinical value of multi-slice spiral CT urography （MSCTU） in the follow-up of patients with a hisfory of previous urothelial cancer. Methods At our department, totally 2800 MSCT urographic examinations were performed from January 2006 to July 2010. Of these, 466 CT urograms in 413 patients evaluated for a history of urothelial cancer were included in the study. MSCT was used for non-enhanced, nephrographic phase and excretory phase scanning that hegan with a contrast bolus injection of 100 ml （370 mgL/ml） contrast material following 100m] saline, which were all given at a rate of 4. 5nfl/s. Axial and three-dimensional reformation images were prospectively evaluated for urotheli- al cancer reeun＇enee. Sensitivity, specificity, accuracy, and positive and negative predictive values were analyzed with the standard of reference, including all available pathological and clinical materials. Results In the postoperative follow-up of patients with previous urothelial cancer, the sensitivity, specificity, accuracy, and positive and negative predictive values for tumor recurrence were 92. 0%, 99. 0%, 97. 1%, 97.2%, and 97. 1%, respectively. Conclusions MSCTU plays an important role in the postoperative follow-up of patients with a history of urothefial cancer for recurrence.