Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC ...Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization （PNV） in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics. Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively. Results Of our sample, 144 cases presented with gross haematuria （83.7%） and 12 with microscopic haematuria （7.0%）. Forty-six cases （26.7%） were detectable by cytology. Filling defect identified 36 positive cases of 172 patients （20.9%）, PNV was present in the images of 105 of 172 patients （61.0%）. The detection rate by PNV （61.0%） was significantly different from that by cytology （26.7%） or by filling defect （20.9%） （P=-0.031, P=-0.001, respectively）. Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors （P=0.028; P=-0.031; P=-0.006, respectively）. Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model （P=-0.042; P=-0.014）.Conclusions Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.展开更多
The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG w...The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG were enrolled for the study from Jan. 2011 to Dec. 2012. All patients under went Intravenous Urography (IVU). MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento;Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with IVU. The anatomical findings were compared with operative findings. Stastical analysis was performed and data expressed as mean ± SD. MRU showed PUJ obstruction in 41 out of 45 patients (91.1%). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace IVP.展开更多
文摘Background Transitional cell carcinoma of the upper urinary tract （UUT-TCC） accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization （PNV） in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics. Methods The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively. Results Of our sample, 144 cases presented with gross haematuria （83.7%） and 12 with microscopic haematuria （7.0%）. Forty-six cases （26.7%） were detectable by cytology. Filling defect identified 36 positive cases of 172 patients （20.9%）, PNV was present in the images of 105 of 172 patients （61.0%）. The detection rate by PNV （61.0%） was significantly different from that by cytology （26.7%） or by filling defect （20.9%） （P=-0.031, P=-0.001, respectively）. Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors （P=0.028; P=-0.031; P=-0.006, respectively）. Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model （P=-0.042; P=-0.014）.Conclusions Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.
文摘The objective of this study was to compare Magnetic Resonance Urography (MRU) with Intravenous Pyelography (IVP) in evaluation of patients with hydronephrosis on ultrasonography. 49 patients of hydronephrosis on USG were enrolled for the study from Jan. 2011 to Dec. 2012. All patients under went Intravenous Urography (IVU). MRU was done to determine the anatomical details and function of each renal unit. MRU was performed on a 1.5 tesla unit (Magneton Avento;Siemens, Erlangen, Germany). Static T2-weighted Magnetic Resonance Urography (MRU) was performed by using a standard fast spin echo technique. Dynamic study was performed after injecting intravenous diuretic followed by Gadolinium contrast media. Morphological results of MRU were compared with IVU. The anatomical findings were compared with operative findings. Stastical analysis was performed and data expressed as mean ± SD. MRU showed PUJ obstruction in 41 out of 45 patients (91.1%). We concluded that MRU can provide complete diagnostic evaluation of entire urinary tract in a single session and has potential to replace IVP.
