超声造影对原发性输尿管移行上皮细胞癌的诊断研究

The application of contrast-enhanced ultrasound in diagnosis of primary ureter transitional cell carcinoma

目的:通过回顾性分析原发性输尿管移行上皮细胞癌(ureter transitional cell carcinoma,UTCC)的超声造影(contrast-enhanced ultrasound,CEUS)表现,探讨CEUS的诊断效能。方法:回顾并分析了26例UTCC患者的资料,所有患者均经手术后病理学检查证实。结果:常规超声显示了26例肿瘤的位置,位于输尿管上、中及下段分别为9、7和10例;65.38%(17/26)的UTCC在常规超声上可清晰显示边界,30.8%(8/26)的UTCC可探及肿瘤内部血流信号。在CEUS上所有UTCC呈动脉期及静脉期高增强表现,肿瘤边界均清晰显示。病理学检查结果证实,T0~T2期及T3~T4期肿瘤各13例,肿瘤横径、输尿管管壁形态和分界在高低分期组间差异显著(P<0.05):即T0~T2期肿瘤横径较小,病变处输尿管管壁形态规则且分界清晰;而T3~T4期肿瘤横径较大,输尿管管壁形态不规则且分界模糊。结论:CEUS较常规超声可更清晰地显示UTCC的边界,肿瘤均呈高增强富血供表现,且CEUS有助于肿瘤的分期评估。

Objective:To investigate the diagnostic performance of contrast-enhanced ultrasound(CEUS)in primary ureter transitional cell carcinoma(UTCC)by retrospectively analysis.Methods:Retrospective study was performed on 26 patients with UTCC,and all the cases were confirmed by pathological dignosis after surgery.Results:Conventional ultrasound showed the location of 26 tumors,including 9 tumors on the upper part,7 tumors on the middle part and 10 tumors on the lower part.65.38%(17/26)of the lesion showed clear boundaries on conventional ultrasound,and 30.8%(8/26)detected blood flow signals in the lesion.On CEUS,all UTCC showed hyper-enhancement in arterial phase,and all the tumor boundary was clearly displayed.Pathological results confirmed that there were 13 cases of T0-T2 stage and T3-T4 stage respectively.The shape and boundary of ureteric wall at the lesion site and the width of the tumor were significant differences between high and low stage groups(P<0.05).The width of the tumor in T0-T2 stage was small,and the ureteral wall was regular and clearly demarcated,while width of the tumor in T3-T4 stage was large,and ureteral wall at the lesion site was irregular and blurred.Conclusion:CEUS showed UTCC more clearly than conventional ultrasound,and all tumors showed as solid and hyper-enhancement lesions in ureteral lumen.Moreover,CEUS was helpful in evaluating tumor staging.