脐尿管腺癌的计算机断层尿路造影(CTU)表现特点及其临床价值

Computed tomography urography(CTU) findings and its clinical value of urachal adenocarcinoma

目的探讨脐尿管腺癌的计算机断层尿路造影(computed tomography urography,CTU)的表现特点及其临床价值,提高对本病的诊断水平。方法回顾性分析8例经手术病理证实的脐尿管腺癌的CTU表现,包括肿块的部位、形态、大小、密度、强化方式及程度等。结果 8例病理诊断均为腺癌或黏液腺癌。CTU均表现为脐尿管与膀胱交界区囊实性或实性软组织肿块,肿瘤与脐尿管长轴一致。4例肿块同时向膀胱腔内外生长,4例肿块位于腔外。肿块形态不规则,7例伴有周围膀胱壁增厚、强化,肿瘤密度欠均匀,5例肿块内可见多少不等钙化,6例可见低密度无强化区。增强扫描示7例呈不均匀轻中度延迟强化。结论 CTU能够反映脐尿管腺癌特殊的发病部位及其特征性CT征象,有利于术前对该病的正确诊断及分期。

Objective To investigate the findings of characteristic computed tomography urography （CTU） and its clinical value for urachal adenocarcinoma in order to improve physician＆prime;s diagnosing ability. Methods CTU findings of 8 patients with pathologically confirmed urachal adenocarcinoma were analyzed retgrospectively,including the site of the mass,shape,size,density,contrast pattern and degree. Results Eight patients were pathologically diagnosed as adenocarcinoma or mucinous adenocarcinoma.CTU findings showed that the solid or cystic and solid soft tissue masses were all located at the junction area of the urachus and bladder.The long axis of the tumors was in consistent with that of the urachus.Four cases occupied both the inside and outside of the bladder dome,and the remaining 4 cases mainly outside.The shapes of the tumors were irregular.Seven cases were accompanied by peripheral bladder wall thickening and enhancement.The attenuation of the lesions was heterogeneous both on plain and contrastenhanced CT scan.Varied amount of calcification and lowdensity areas without enhancement were seen in 5 cases and 6 cases,respectively.Mild to moderate heterogeneous delayed enhancement of the masses was found in 7 cases. Conclusions CTU can demonstrate the special location and characteristic CT features of urachal adenocarcinoma,which may be helpful to preoperative diagnosis and staging.