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目的探讨多层螺旋CT三维成像技术(3D-MSCT)在原发性输尿管癌诊断中的应用价值。方法对14例无痛性肉眼血尿,经静脉尿路造影(IVU)、B超、膀胱镜等检查除外肾、膀胱肿瘤,疑为输尿管占位性病变的患者,选用3D-MSCT检查,结果与手术病理结果进行比较。结果3D-MSCT发现输尿管占位性病变13例,曲面重建图像表现为输尿管腔内软组织影,约0.5cm×0.5cm~3.0cm×4.5cm,管腔内充盈缺损,管腔偏纵轴狭窄,输尿管上段及肾盂不同程度扩张。影像学诊断:原发性输尿管癌10例,输尿管良性息肉3例,另1例为输尿管子宫内膜异位症。术后病理检查结果与3D-MSCT诊断结果完全一致。结论3D-MSCT可直观输尿管腔内占位性病变,在某种程度上可以替代IVU,对诊断原发性输尿管肿瘤有重要价值。
Objective To investigate the value of 3D-MSCT in the diagnosis of primary ureteral carcinoma. Methods 14 cases of painless gross hematuria, intravenous urography (IVU), B ultrasound, cystoscopy and other tests except renal and bladder tumors, suspected ureteral space-occupying lesions were selected 3D-MSCT examination results and Surgical pathology results were compared. Results 3D-MSCT revealed 13 cases of ureteral space-occupying lesions. The curved surface reconstruction showed soft tissue of the ureter with a diameter of 0.5cm × 0.5cm ~ 3.0cm × 4.5cm. The defect was filled in the lumen and the longitudinal axis of the lumen was narrow. Upper ureter and renal pelvis to varying degrees of expansion. Imaging diagnosis: 10 cases of primary ureteral carcinoma, 3 cases of benign polyps of the ureter, the other case of ureteral endometriosis. Postoperative pathological findings and 3D-MSCT diagnostic results are exactly the same. Conclusion 3D-MSCT can visualize the space-occupying lesions of the ureter, which can replace IVU to some extent. It is of great value in the diagnosis of primary ureteral tumors.