Bueno Chomón Gonzalo, Téllez Martínez-Fornés Miguel, Alegre Bernal Nieves, Gimeno Albo Fernando
Servicio de Urologia, Hospital "Severo Ochoa", Leganés, Madrid, España.
Arch Esp Urol. 2004 Apr;57(3):205-26.
To perform the adequate treatment of upper urinary tract lesions it is very important to have an exact diagnosis. When the suspicion of an upper tract urothelial tumor is established the initial evaluation is carried out by imaging diagnostic tests (intravenous urography, pyelography, and others). The association of radiological tests and urine cytologies allows us to get to a correct diagnosis in most cases. Upper urinary tract endoscopy solves some equivocal cases, but sometimes it is impossible to clarify the nature of the lesion in spite of a comprehensive diagnostic effort. Therapeutic decision should be individualized in these cases. The objective of this article is to describe the various features of upper tract urothelial tumors in a variety of available imaging tests, and to review all conditions that may have similar images, describing the characteristic radiological findings for each of them. We discuss about differential diagnosis and perform a critical evaluation of the diagnostic difficulties that occasionally present upper urinary tract diseases.
为了对上尿路病变进行充分治疗,准确的诊断非常重要。当怀疑上尿路尿路上皮肿瘤时,初始评估通过影像学诊断检查(静脉肾盂造影、肾盂造影等)进行。放射学检查和尿液细胞学检查相结合,使我们在大多数情况下能够做出正确诊断。上尿路内镜检查解决了一些模棱两可的病例,但有时尽管进行了全面的诊断努力,仍无法明确病变的性质。在这些情况下,治疗决策应个体化。本文的目的是描述各种可用影像学检查中上尿路尿路上皮肿瘤的各种特征,并回顾所有可能具有相似影像的情况,描述每种情况的特征性放射学表现。我们讨论鉴别诊断,并对偶尔出现的上尿路疾病的诊断困难进行批判性评估。