MSCT对原发性输尿管癌的诊断价值  

The Diagnostic Value of MSCT for Primary Ureteral Carcinoma

作　　者：郝建成 郝金钢[2] 

机构地区：[1]芜湖市第一人民医院影像科,安微芜湖241000 [2]昆明医科大学第二附属医院影像科,云南昆明650101

出　　处：《昆明医科大学学报》2015年第6期62-65,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2011FZ128)

摘　　要：目的探讨MSCT对原发性输尿管癌的诊断价值.方法收集芜湖市第一人民医院确诊并手术治疗的原发性输尿管癌16例,分析所有病例的256层CT影像特点.所有病例均做256层CT平扫＋增强扫描,增强扫描包括动脉期、实质期、延迟期.所有病例均做多平面重组（MPR）、曲面重建（CPR）,11例做SCTU重建,对病灶不明显的做薄层重建.结果所有病例均显示梗阻部位,平扫15例准确显示病灶,增强扫描均清楚显示.肿瘤形态：管腔内柱形软组织肿块影6例;管腔内向心性或偏心性肿块影3例;管壁不规则增厚4例;管壁结节影2例;病灶显示不清,仅显示梗阻部位1例.强化方式：增强后病灶明显强化12例,轻度强化3例,梗阻部位管壁线状强化1例.继发征象：所有病例梗阻部位以上输尿管及肾盂不同程度扩张积水,1例皮质萎缩.正确诊断15例,疑似病例1例.诊断准确度为93.7%（15/16）,95%CI为70.2%-99.7%,灵敏度为100%（16/16）,95%CI为79.3%-99.8%.结论 MSCT多期容积扫描及多功能的重建技术可大大提高输尿管癌的诊断准确性,具有较高的临床应用价值.Objective To investigate the value of MSCT diagnosis for primary ureteral carcinoma. Methods16 cases of primary ureteral carcinoma diagnosed and treated in our hospital were collected, and 256 layers CT imaging features of all cases were analyzed. All cases were examined with 126 layers of scan and contrast- enhanced CT scan, including arterial phase,parenchymal phase and delayed phase enhanced. All cases were given multiple plane reconstruction（MPR） and curved planar reconstruction（CPR）. Among them, 11 cases underwent SCTU reconstruction, and thin slice reconstruction was required if lesions were not obvious. Results All cases showed obstruction,15 cases scan showed lesions accurately, and all cases showed lesions clearly using the enhancement scanning. Tumor morphology displayed the soft tissue masses of lumen column in 6 cases, the lumen introverted disposition or eccentric mass in 3 cases, irregular wall thickening in 4 cases, and the pipe wall nodules in 2 cases.Only 1 case showed obscurity lesions of obstruction. With enhancement scanning, lesions showed obvious enhancement in 12 cases, slight enhancement in 3 cases, and obstruction wall linear enhancement in 1 case.Secondary sings were observed, different degrees of hydronephrosis and dilatation in the site of obstruction of ureter and pelvis in all cases and cortical atrophy in 1 case. 15 cases were correctly diagnosed and 1 case was suspected. The diagnostic accuracy was 93.7%（15/16）, with 95% CI of 70.2%- 99.7%, and the sensitivity was 100%（16/16）, with 95% CI of 79%- 99.8%. Conclusion Multiphase MSCT volume scanning and multi functionalreconstruction technique can greatly improve the accuracy of diagnosis of ureteral carcinoma, has a high clinical application value.

关 键 词：输尿管癌 MSCT 容积 重建 

分 类 号：R737.13[医药卫生—肿瘤]