Caoili Elaine M, Cohan Richard H, Inampudi Prasuna, Ellis James H, Shah Rajal B, Faerber Gary J, Montie James E
Department of Radiology, University of Michigan Health System, B1-132 Taubman Center 0302, 1500 E Medical Center Dr., Ann Arbor, MI 48109-0302, USA.
AJR Am J Roentgenol. 2005 Jun;184(6):1873-81. doi: 10.2214/ajr.184.6.01841873.
The purpose of our study was to review the MDCT urography appearance of pathologically proven transitional cell carcinomas of the renal collecting system and ureter and to correlate the MDCT urography findings with pathology findings.
Of 370 MDCT urography examinations performed over an 18-month period, 18 patients were diagnosed with 27 renal collecting system or ureteral urothelial neoplasms at endoscopic biopsy (n = 8) or surgery (n = 19). Initial MDCT reports were reviewed to determine the sensitivity of original reviewers in detecting these neoplasms. Two radiologists also retrospectively reviewed these scans and characterized the CT appearance of the neoplasms on both axial CT and 3D reformatted images. Findings at retrospective review were correlated with pathology results to determine whether any CT features could be used to predict tumor grade.
Eighteen of 27 neoplasms were prospectively identified on MDCT urography, and an additional six neoplasms were detected on retrospective review. Three ureteral neoplasms could not be visualized. The 24 retrospectively detected neoplasms had three distinct MDCT appearances: circumferential urothelial wall thickening (n = 14), small masses (> 5 mm in maximal diameter) (n = 5), and large masses (> 5 mm in maximal diameter) (n = 5). All detected lesions could be seen on axial excretory phase images provided wide window settings were reviewed; however, only six were detected on 3D reconstructions. MDCT urography appearance did not correlate with tumor grade.
MDCT urography is a promising technique for detecting upper urinary tract neoplasms. The static 3D reconstructions used in this study are insufficient for visualization. Axial image review remains essential for tumor identification.
我们研究的目的是回顾经病理证实的肾集合系统和输尿管移行细胞癌的MDCT尿路造影表现，并将MDCT尿路造影结果与病理结果相关联。
在18个月期间进行的370例MDCT尿路造影检查中，18例患者经内镜活检（n = 8）或手术（n = 19）诊断为27例肾集合系统或输尿管尿路上皮肿瘤。回顾最初的MDCT报告以确定最初阅片者检测这些肿瘤的敏感性。两名放射科医生也回顾性地分析了这些扫描图像，并在轴位CT和三维重建图像上对肿瘤的CT表现进行了特征描述。回顾性分析结果与病理结果相关联，以确定是否有任何CT特征可用于预测肿瘤分级。
27例肿瘤中有18例在MDCT尿路造影检查中被前瞻性识别，回顾性分析又发现了另外6例肿瘤。3例输尿管肿瘤未能显示。回顾性检测到的24例肿瘤有三种不同的MDCT表现：尿路上皮壁环形增厚（n = 14）、小肿块（最大直径>5 mm）（n = 5）和大肿块（最大直径>5 mm）（n = 5）。所有检测到的病变在提供宽窗设置的轴位排泄期图像上均可看到；然而，三维重建仅检测到6例。MDCT尿路造影表现与肿瘤分级无关。
MDCT尿路造影是检测上尿路肿瘤的一种有前景的技术。本研究中使用的静态三维重建不足以显示病变。轴位图像分析对于肿瘤识别仍然至关重要。
