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目的 探讨螺旋CT仿真膀胱镜 (CTVC)的临床应用价值及限度。方法 3 6例临床怀疑膀胱病变的患者 ,都经纤维膀胱镜检查 ,并有病理证实。应用螺旋CT采集排泄期的图像做CTVC成像 ,双盲法与轴位、纤维膀胱镜所见对照分析。结果 CTVC能清楚地显示膀胱腔内的各种正常解剖结构 ,8例正常膀胱中 7例可见 11侧输尿管开口 ;CTVC对膀胱腔内病变的部位、大小、数目、形态及侵犯范围的显示均与纤维膀胱镜基本一致 ;膀胱癌的检出率为 94.7% ,2个 <5mm的肿瘤CTVC显示清楚 ,而轴位图像未显示 ;CTVC检测膀胱壁增厚及膀胱外侵犯的状况不如轴位和MPR图像 ,CTVC上假性病灶 1例。结论 CTVC对膀胱病变的显示和诊断是一种较可靠的、非侵袭性的方法 ,但需要膀胱内造影剂充盈良好 ,且必须结合轴位和MPR图像才能对膀胱病变做出全面、准确的评价。
Objective To investigate the value and limit of clinical application of spiral CT cystoscopy (CTVC). Methods Thirty-six patients with suspected bladder lesions were examined by cystoscopy and confirmed by pathology. Spiral CT was used to collect images of excretory phase for CTVC imaging, double-blind method and axial, fiber cystoscopy see control analysis. Results CTVC could clearly show various normal anatomical structures in the bladder cavity. In 8 cases of normal bladder, 11 cases of ureter opening were visible. The location, size, number, shape and extent of invasion of CTVC in bladder cavity showed The cystoscopy of fibroids was basically the same. The detection rate of bladder cancer was 94.7%. The tumor CTVC of 2 <5mm was clear, but the axial image was not displayed. The status of CTVC in detecting bladder wall thickening and extracranial invasion was inferior to axial and MPR Image, CTVC on a fake lesions in 1 case. Conclusions CTVC is a reliable and noninvasive method to display and diagnose bladder lesions, but it needs a good filling of intravesical contrast medium and must be combined with axial and MPR images to make a comprehensive and accurate evaluation of bladder lesions .