膀胱癌的CT诊断与分期

Application of CT in the diagnosis and staging of bladder carcinoma

目的提高认识膀胱癌的CT诊断,分析膀胱癌的CT分期及鉴别诊断。方法回顾性分析36例经手术或膀胱镜检活检,病理证实为膀胱癌的CT表现。结果CT检查对膀胱癌极为敏感,本组CT诊断膀胱癌36例,其正确诊断率94.7%,漏诊1例,误诊为膀胱炎1例;CT分期与病理符合者28例,符合率77.8%。结论CT对膀胱癌诊断准确性极高,但CT对膀胱壁浸润程度的区分不甚理想,常致分期不足或分期过度,特别是早期分期准确性较低,但对膀胱壁外浸润或盆腔转移,蔓延较敏感。膀胱癌主要与前列腺癌,前列腺增生膀胱内血凝块及膀胱乳头状瘤等鉴别。

Objective To investigate the effect of CT on the diagnosis and sta ging of bladder carcinoma.Methods CT manifestation of 38 patients with bladder c arcinoma confirmed by operation,cystoscopic biopsy and pathological examination were analyzed retrospectively.Results CT examination was very sensitivity to dia gnosis of bladder carcinoma.The rate of comfirmed diagnosis was 94.7%(36/38).Co nclusion CT can provide a more accurate information for the diagnosis of bladder carcinoma,and it is not so idea to differentiate the infiltrated degree of vesi cal wall.But,it is more sensitivity in the infiltration of extravesical wall or pelvic metastasis and spread.The bladder carcinoma should be differentiated from prostatic carcinoma,prostatic hyperplasia,intravesical clot,papilloma of bladde r and so on.