原发输尿管癌影像诊断评价

Evaluation on Diagnostic Imaging of Primary Ureteral Carcinoma

目的 :回顾性评价常用影像学方法诊断原发输尿管癌的价值。材料和方法 :我院近 2 0年共手术治疗原发输尿管癌 10 3例。术前影像检查包括 :B超 ,静脉肾盂造影 ,逆行输尿管造影 ,CT和MRI。以手术所见和病理诊断为参照 ,对术前原始影像诊断报告进行比较分析 ;以原诊断报告描述管壁增厚、占位、充盈缺损 ,诊断意见提示肿瘤者视为准确。结果 :B超、静脉肾盂造影、逆行输尿管造影、CT和MRI的总体使用率分别为 95 %、63 %、3 4%、5 6%和 3 4% ,诊断符合率分别为 45 %、15 %、83 %、5 0 %和 89% ,假阴性率分别为 4%、2 %、3 %、7%和 2 %。结论 :B超的使用率最高 ,MRI的诊断符合率最高 ,两者结合可能是原发输尿管癌诊断的最佳影像组合。

Puepose: To retrospectively evaluate the value of common used diagnostic imaging facilities in primary ureteral carcinoma. Materials and Methods: Total 103 cases of primary ureteral carcinoma were taken on operation therapy in our hospital in recent 20 years. The pre operation imaging examination were used including ultrasound, IVP, retrograde ureteropyelography, CT and MRI. Comparing operation and pathology diagnoses with that of primitive imaging diagnostic data, only those of description with abnormal thickening of ureteral wall, occupation lesions, filling defects in the reports and of impression with tumors were taken as correct diagnosis. Results: The overall employ rate of ultrasound, IVP, retrograde ureteropyelography, CT and MRI was 95%,63%,34%,56% and 34% respectively, the accurate rate of diagnosis was 45%,15%,83%,50% and 89% respectively, and the false negative rate was 4%,2%,3%,7% and 2% respectively. Conclusion: While ultrasound is the most broadly used method in the diagnosis of primary ureteral carcinoma, MRI is the most accurate method. Combination of these two diagnostic methods may be highly effective for diagnosing primary ureteral carcinoma.