脐尿管癌的多层螺旋CT诊断价值分析

MSCT diagnosis of urachalcarcinoma

目的探讨多层螺旋CT在诊断脐尿管癌的应用价值。方法回顾性分析9例经手术病理证实的脐尿管腺癌患者的CT表现。结果经横断位图像及重建矢状位图像显示9例肿瘤均表现为脐与膀胱顶部之间中线部位的占位性病变。9例中肿瘤浅分叶7例,类圆形2例,6例为囊实性,3例为实性;平扫肿瘤内可见点状、斑片状或环形钙化5例,增强后肿瘤实性成分明显强化7例,7例肿瘤局部与膀胱分界不清,其中3例见肿瘤压迫/突入膀胱,肿瘤腹膜转移合并腹腔积液2例,胸壁、腹壁及腹腔内转移1例,术前诊断脐尿管癌7例,1例误诊为膀胱癌,1例误诊为卵巢囊腺瘤,CT诊断符合率78%。结论脐尿管癌的多层螺旋CT表现有一定特征性,多层螺旋CT检查并对其定性和定位诊断具有很高的应用价值。

Objective To explore the application value of multi-slice spiral CT（MSCT） in the diagnosis of ura-chalcarcinoma. Methods The CT manifestations of 9 patients with pathologically confirmed urachalcarcinoma were retrospectively analyzed. Results The axial images and sagittal reconstruion images showed that all of the 9 cases of tumors presented as the space-occupying lesions at the midline between the navel and the top of the bladder, includ-ing 7 shallow leaf and 2 round, 6 of them were cystic and solid and 3 of them were solid and 7 solid tumors were of large flakes liquefaion necrosis in the centers; Five cases can been seen the dotted patchy or ring calcification via plain scanning the tumor, 7 cases with the tumor solid component enhanced via enhancement, 7 cases tumor were of locally unclear boundaries with the bladder, including 3 cases of tumor compression/broke into the bladder tumor peritoneal metastases with ascites in 2 cases, chest wall, abdominal wall and intra-abdominal metastasis, the preopera-tive diagnosis of urachalcarcinoma in 7 cases, 1 case was misdiagnosed as bladder cancer, 1 case was misdiagnosed as ovarian cystadenoma, the accordance rate of the CT diagnosis was 78%. Conclusion The multi-slice spiral CT mani-festations of urachal cancer have certain characristics and the multislice CT and its qualitative and positioning diagno-sis are highly valuable.