输尿管癌与输尿管息肉的螺旋CT诊断  

Helical CT Diagnosis of the Ureteral Carcinoma and Ureteral Polypi

作　　者：蒋高民[1] 赵绘萍[1] 陈新哲[1] 

机构地区：[1]吉林医药学院附属医院放射线科,吉林132013

出　　处：《临床放射学杂志》2009年第6期834-836,共3页Journal of Clinical Radiology

摘　　要：目的探讨输尿管癌与输尿管息肉的螺旋CT诊断及鉴别诊断要点。资料与方法回顾性分析经病理证实的27例输尿管息肉患者及33例输尿管癌患者螺旋CT平扫及4期增强扫描,以及多平面重组(MPR)、曲面重建(CPR)和CT尿路成像(CTU)的影像表现。观察输尿管息肉和输尿管癌的强化方式、形态特征及二者的CT表现差异。结果27例输尿管息肉26例诊断正确,33例输尿管癌31例诊断正确。输尿管息肉强化峰值位于平衡期,CT值增加幅度40～90HU,平均63.5HU;输尿管癌强化峰值位于静脉期,CT值增加幅度20～60HU,平均42.5HU。27例输尿管息肉均表现为腔内软组织肿块,其中15例其内可见高密度,外壁光滑,与周围组织分界清楚;33例输尿管癌表现为腔内软组织肿块22例,管壁增厚型5例,腔外肿块型6例,1例肿瘤内可见高密度。15例病变管壁外脂肪间隙模糊。结论螺旋CT增强扫描轴位图像及MPR、CPR、CTU三维后处理图像能够准确显示输尿管息肉及输尿管癌的病变形态及强化方式,在二者诊断及鉴别诊断方面具有一定的临床应用价值。Objective To discuss the helical CT diagnosis and differential diagnosis of the ureteral carcinoma and ureteral polypi. Materials and Methods The precontrast and four-phase postcontrast helical CT scans were performed in 27 patients with ureteral polypi and 33 patients with ureteral carcinoma confirmed by pathology. The multiplanar reformation （MPR）, the curve reformation（CPR） and spiral CT-urography （SCTU） images were generated from the volumetric data. The postcontrast style and morphology of ureteral carcinoma and ureteral polypi were observed respectively. Results 26 of 27 ureteral polypi and 31 of 33 ureteral carcinoma were diagnosed accurately by helical CT. The enhancement peak of ureteral polypi was in balance phase, the increasing value was 40 -90HU with the average 63.5HU; the enhancement peak of ureteral carcinoma was in venous phase, the increasing value was 20 -60HU with the average 42.5HU. 27 ureteral polypi were all displayed as intraluminal mass, 15 of 27 were found hyperdensity focus, the outer ureteral wall was smooth, the borderline with surrounding structure was clear. Of 33 ureteral carcinomas, 22 cases were displayed as intralumimal mass, 5 cases with ureteral wall thickening, 6 case was depicted as extraluminal, 1 case were found hyperdensity focus in the mass, the fat gap was obscured in 15 cases. Conclusion Combined with the multiple-phase axial images, MPR and SCTU images, helical CT can show the morphology and the enhancement style of carcinoma and polypi, and it is valuable in diagnosis and differential diagnosis of them.

关 键 词：输尿管癌 输尿管息肉 体层摄影术 X线计算机 

分 类 号：R737.13[医药卫生—肿瘤] R693[医药卫生—临床医学]