CDUS与MSCT在膀胱尿路上皮癌中的临床应用价值比较

Clinical value of color Doppler ultrasound and multi-slice computed tomography in comparative diagnosis of urothelial carcinoma

目的:探讨彩色多普勒超声(CDUS)与多层螺旋CT(MSCT)对膀胱尿路上皮癌的诊断价值。方法:回顾性分析42例膀胱尿路上皮癌患者的CDUS及MSCT资料,分别统计两种检查方法对膀胱不同部位尿路上皮癌肿瘤的检出率并与术后手术病理检出肿瘤数量比较,归纳膀胱尿路上皮癌的CDUS及MSCT表现。结果:42例膀胱肿瘤患者手术共检出92枚(颈部及三角区59枚,其它部位33枚)。术前膀胱颈部及三角区肿瘤检出率MSCT(71.19%)高于CDUS(44.07%),且差异具有统计学意义(P<0.05);其它部位肿瘤检出率MSCT(75.76%)高于CDUS(69.70%),但差异无统计学意义(P>0.05)。不区分病灶位置,MSCT检出率(71.19%)高于CDUS检出率(44.07%),且差异具有统计学意义(P<0.05)。膀胱尿路上皮癌CDUS主要表现为自膀胱壁呈结节状、乳头状或菜花状突向膀胱腔内(69.39%),肿瘤呈中等较均匀回声(71.43%),肿瘤内可检出血流信号(83.67%)。膀胱尿路上皮癌MSCT主要表现为乳头状或菜花状肿块(68.65%),瘤体多为高于尿液的软织密度(88.06%),增强后多数为中度以上强化(79.11%),多数瘤体均匀强化(85.07%)。结论:膀胱尿路上皮癌具有较为典型的CDUS和MSCT表现,二者均是膀胱肿瘤检出的重要手段,肿瘤病灶检出率MSCT优于CDUS,膀胱颈部及三角区的肿瘤容易漏诊,CT增强延时扫描及多平面重建等后处理技术的综合运用是提高病灶检出率最有效的手段。

Objective： To evaluate the value of color Doppler ultrasound（ CDUS） and multi-slice computed tomography（ MSCT） in the diagnosis of urothelial carcinoma. Methods： According to the results of 42 patients with the bladder urothelial carcinoma to summarize the characteristics of bladder urothelial carcinoma in these two diagnostic methods. Results： 92 tumors had been detected in 42 cases of bladder cancer（ neck and triangular area59,other parts of the organism 33）. The detection rate of bladder neck and trigone cancer by MSCT examination（ 71.19%） was far better than CDUS test（ 44.07%）,and with significant difference in statistics（ P 〈0.05）; At other parts of the tumor MSCT detection rate was 75. 76% and the CDUS detection rate was 69. 70%,but there was no significant difference（ P 〉 0. 05）. The MSCT detection rate（ 71. 19%） was higher than CDUS detection rate（ 44. 07%） in the other places,and with significant difference（ P 〈 0. 05）. Bladder urothelial carcinoma protruding into the bladder lumen（ 69. 39%） with the forms of tubercle,papilla and cauliflower. Meanwhile,the cases which showed moderate uniform echo were 35（ 71. 43%）,and the number of cases can be detected the blood flow signals within the tumor was 83. 67% in the CDUS. Normally,in MSCT bladder urothelial carcinoma mainly appears as papillary or cauliflower mass（ 68. 65%）,the tumor density was higher than urine（ 88. 06%）,and the majority of the tumor was to be shown moderate strengthening（ 79. 11%） after enhancement,while the number of cases showed homogeneous enhancement was 57 cases（ 85. 07%）. Conclusion： Bladder urothelial carcinoma perform the typical features in CDUS and MSCT,so these two methods both are the important ways of bladder cancer examinations. In comparison,in the tumor lesion detection rate,MSCT is superior than CDUS. Tumors of the bladder neck and the triangular area are easily be missed,The integrated use of CT enhanced latency scans and multi-planar reconstruction in post-processing technology which can improve the detection rate of lesion are the most effective way of cancer examinations.