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目的评价多层螺旋CT泌尿系成像(multi-slice spiral computed tomography urography,MSCTU)在尿路上皮癌患者随访中的临床价值。方法 2006年1月～2010年7月我科共行2800例MSCTU检查,其中413名尿路上皮癌患者术后随访共行466例MSCTU检查,包括平扫、肾实质期和排泄期三期扫描。顺序注射造影剂100ml(370mgI/ml)和100ml生理盐水,注射速度均为4.5ml/s。对MSCTU轴位及三维后处理图像进行前瞻性诊断,以评价是否有肿瘤复发。分析诊断的敏感性、特异性、准确性、阳性和阴性预测值。参考标准为病理学结果和随访临床资料。结果对尿路上皮癌患者的术后随访中,MSCTU诊断肿瘤复发的敏感性、特异性、准确性、阳性和阴性预测值分别为92.0%、99.0%、97.1%、97.2%和97.1%。结论 MSCTU对随访尿路上皮癌患者肿瘤复发具有重要的临床价值。
Objective To evaluate the clinical value of multi-slice spiral computed tomography (MSCTU) in the follow-up of patients with urothelial carcinoma. Methods From January 2006 to July 2010, 2800 cases of MSCTU were examined in our department. Among them, 466 patients with urothelial carcinoma were followed up for 466 MSCTU examinations, including three stages of plain scan, renal parenchyma and excretory phase . Inject sequentially contrast agent 100ml (370mgI / ml) and 100ml normal saline, the injection speed is 4.5ml / s. Prospective diagnosis of MSCTU axial and three-dimensional postprocessing images was performed to assess whether there was a tumor recurrence. Diagnostic sensitivity, specificity, accuracy, positive and negative predictive values were analyzed. Reference standards for pathology and follow-up clinical data. Results The sensitivity, specificity, accuracy, positive and negative predictive value of MSCTU in diagnosing urothelial carcinoma were 92.0%, 99.0%, 97.1%, 97.2% and 97.1% respectively. Conclusion MSCTU has important clinical value in the follow-up of tumor recurrence in patients with urothelial carcinoma.