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目的探讨多层螺旋CT扫描结合三维重建对原发输尿管癌的诊断价值。方法收集经手术病理证实的原发输尿管癌患者11例。所有患者常规行全尿路CT平扫及增强扫描,延迟8～120min行多次全尿路扫描,薄层重建数据应用AW4.3软件进行MPR、CPR、MIP及VR重建及三维成像,CPR选取动脉期、MIP及VR选取延迟期效果较好。结果 CT全部检出病灶。平扫显示病灶为输尿管腔内软组织肿块、管壁增厚及不同程度的扩张积水,增强扫描动、静脉期可见病灶呈不同程度强化。MPR从不同角度显示病变本身及病变与周围组织器官的关系。CPR通过动脉期重建对输尿管完整显示使病变整体形态范围变得更清晰。MIP、VR在延迟期能立体多方位显示输尿管充盈情况、局部梗阻形态等。结论多层螺旋CT扫描结合三维重建基本上对原发输尿管癌做出正确诊断,提高小病灶检出率,为临床手术治疗提供可靠的信息,是很好的影像学检查方法。
Objective To investigate the diagnostic value of multi-slice spiral CT combined with three-dimensional reconstruction in primary ureteral carcinoma. Methods Eleven patients with primary ureteral carcinoma confirmed by surgery and pathology were collected. All patients underwent routine CT scan and enhanced CT scan of the urinary tract, delayed multiple urethral catheterization after 8 ~ 120 min. AW4.3 software was used to perform MPR, CPR, MIP and VR reconstruction and three-dimensional imaging, CPR selection Arterial phase, MIP and VR selection delay period is better. Results CT all detected lesions. Plain lesions showed ureteral luminal soft tissue mass, wall thickening and varying degrees of expansion of water, enhanced scanning, venous phase showed lesions were enhanced to varying degrees. MPR from different angles show the lesion itself and lesions and the surrounding tissue and organs. CPR reconstruction of the ureter on the integrity of the ureteral lesions show the overall shape of the range became clearer. MIP, VR in the delay period can be three-dimensional display of ureteral filling, local obstruction morphology. Conclusion Multi-slice spiral CT combined with three-dimensional reconstruction basically diagnoses primary ureteral carcinoma and improves the detection rate of small lesions. It provides reliable information for clinical surgical treatment and is a good imaging examination method.