Kwak Kyung Won, Park Byung Kwan, Kim Chan Kyo, Lee Hyun Moo, Choi Han Yong
Department of Urology, Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Radiol. 2008 Feb;49(1):121-6. doi: 10.1080/02841850701635200.
Urothelial carcinoma is the most common malignant tumor arising from the pelvocalyceal system. Helical computed tomography (CT) is probably the best preoperative-stage modality for the determination of treatment plan and prognosis.
To obtain helical CT imaging features suggesting advanced pelvocalyceal urothelial carcinoma.
Preoperative CT images in 44 patients with pelvocalyceal urothelial carcinoma were retrospectively reviewed and correlated with the pathological examination to determine imaging features suggesting stage III or IV of the disease.
Pathological stages revealed stage I in 16, stage II in three, stage III in 17, and stage IV in eight patients. Seven patients had metastatic lymph nodes. CT imaging showed that renal parenchymal invasion, sinus fat invasion, and lymph node metastasis were highly suggestive of advanced urothelial cell carcinoma (P<0.05). Helical CT sensitivity, specificity, and accuracy for advanced pelvocalyceal urothelial carcinoma were 76% (19/25), 84% (16/19), and 80% (35/44), respectively.
Preoperative helical CT may suggest imaging features of advanced urothelial carcinoma, influencing treatment plan and patient prognosis, even though its accuracy is not so high.
尿路上皮癌是肾盂肾盏系统最常见的恶性肿瘤。螺旋计算机断层扫描（CT）可能是确定治疗方案和预后的最佳术前分期方法。
获取提示晚期肾盂尿路上皮癌的螺旋CT成像特征。
回顾性分析44例肾盂尿路上皮癌患者的术前CT图像，并与病理检查结果进行对照，以确定提示疾病Ⅲ期或Ⅳ期的影像学特征。
病理分期显示，16例为Ⅰ期，3例为Ⅱ期，17例为Ⅲ期，8例为Ⅳ期。7例有转移淋巴结。CT成像显示，肾实质侵犯、窦脂肪侵犯和淋巴结转移高度提示晚期尿路上皮癌（P<0.05）。螺旋CT对晚期肾盂尿路上皮癌的敏感性、特异性和准确性分别为76%（19/25）、84%（16/19）和80%（35/44）。
术前螺旋CT可能提示晚期尿路上皮癌的影像学特征，影响治疗方案和患者预后，尽管其准确性并非很高。
