论文部分内容阅读
目的探讨原发性输尿管癌与输尿管转移癌的多层螺旋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12例原发性输尿管癌患者及8例输尿管转移癌患者的多层螺旋CT资料,所有病例常规进行CT平扫及3期增强扫描,并采用CT尿路成像(CTU)、多平面重组(MPR)、曲面重组(CPR)等方法重组,观察输尿管癌和转移癌的影像特点、强化方式及两者的CT表现差别。结果 12例输尿管癌多数发生于左侧;病理为移行细胞癌11例,鳞癌2例;CT表现为输尿管梗阻端管腔内软组织肿块影,增强扫描以静脉期强化较明显,MPR及CPR显示输尿管腔内充盈缺损或管腔中断,并伴有梗阻端以上输尿管、肾盂的轻中度扩张积水;8例输尿管转移癌表现为输尿管管壁增厚或管腔中断以及输尿管周围软组织肿块影,部分病例可合并有管腔内充盈缺损征象,其梗阻上方输尿管明显扩张;增强扫描病变段输尿管的强化程度与原发肿瘤基本一致,CTU显示对比剂通过困难或不能通过,病变输尿管僵硬。结论多层螺旋CT3期增强扫描结合CTU、MPR、CPR等后处理技术在原发性输尿管癌及输尿管转移癌的诊断和鉴别诊断方面具有一定的临床应用价值。
Objective To investigate the diagnosis and differential diagnosis of primary ureteral carcinoma and ureteral carcinoma with multi-slice spiral CT. Materials and Methods Retrospective analysis of 12 cases of primary ureteral carcinoma confirmed by pathology and 8 cases of ureteral metastasis in patients with multi-slice spiral CT data, all cases routine CT plain scan and three enhanced scan, and CT urinary tract CTU, MPR and CPR were used to observe the features of the ureteral carcinoma and the metastatic carcinoma. Results The majority of ureteral carcinoma occurred on the left side in 12 cases. The pathological findings were transitional cell carcinoma (11 cases) and squamous cell carcinoma (2 cases). The CT showed ureteral obstruction endodermal soft tissue mass Ureteral cavity filling defect or lumen was interrupted, accompanied by obstruction end ureter, renal pelvis mild to moderate expansion of water; 8 cases of ureteral metastasis showed ureteral wall thickening or lumen breakage and ureteral soft tissue mass, Some cases may be combined with signs of intraluminal filling defect, the obstruction of ureteral obstruction significantly dilated; enhancement of the lesion enhanced ureteral involvement with the primary tumor is basically the same, CTU shows that the contrast agent through the difficult or can not pass, ureteral stiffness of the disease. Conclusions Multi-slice spiral CT3 enhanced scanning combined with CTU, MPR, CPR and other post-processing techniques have certain clinical value in the diagnosis and differential diagnosis of primary ureteral carcinoma and ureter metastatic carcinoma.