Battista Giuseppe, Sassi Claudia, Schiavina Riccardo, Franceschelli Alessandro, Baglivo Emanuela, Martorana Giuseppe, Canini Romeo
Clinical Department of Radiological and Histopatological Sciences, Divison of Diagnostic Imaging, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Abdom Imaging. 2009 Jan-Feb;34(1):107-12. doi: 10.1007/s00261-008-9387-5.
To assess the usefulness of CT virtual endoscopy (VE) as an integration of CT-urography, for the detection of upper urinary tract tumor in patients with hematuria.
Fourteen patients with hematuria and high risk of transitional cell carcinoma of the upper urinary tract underwent urinary cytology, ultrasonography, excretory urography, cystoscopy, CT-urography with VE, and optical ureteroscopy. The CT urograms and VE were correlated with the pathological findings of surgical specimen (6/14) and cytological examination of ureteroscopy biopsy (8/14).
VE revealed three renal pelvic and one ureteral tumors, not producing further information did not detected at CT-urography. In two patients VE showed findings strongly indicative of malignancies, not noticed at CT-urography: ureteroscopic biopsy revealed an advanced dysplastic lesion and a malignancy, confirmed at surgery. In one patient VE was questionable (narrowing of the distal ureter) and ureteroscopic biopsy revealed an inflammation. Finally, VE diagnosed a fibrosis of the lumbar ureteral tract, confirmed at ureteroscopic biopsy. In other six patients, VE and ureteroscopy did not find abnormalities.
VE should be useful as an integration of CT-urography for a complete evaluation of the upper urinary tract in patients with suspected tumor, limiting the need for fiberoptic ureteroscopic examination.
评估CT虚拟内窥镜检查（VE）作为CT尿路造影的一种补充手段，在血尿患者上尿路肿瘤检测中的应用价值。
14例有血尿且患输尿管移行细胞癌高风险的患者接受了尿细胞学检查、超声检查、排泄性尿路造影、膀胱镜检查、带VE的CT尿路造影以及输尿管光学镜检查。CT尿路造影和VE结果与手术标本的病理结果（6/14）以及输尿管镜活检的细胞学检查结果（8/14）进行了对比。
VE发现了3例肾盂肿瘤和1例输尿管肿瘤，这些在CT尿路造影中未被发现。在2例患者中，VE显示出强烈提示恶性肿瘤的表现，而CT尿路造影未注意到：输尿管镜活检发现了一个高级发育异常病变和一个恶性肿瘤，手术证实。在1例患者中，VE结果存疑（输尿管远端狭窄），输尿管镜活检显示为炎症。最后，VE诊断出腰段输尿管纤维化，输尿管镜活检证实。在其他6例患者中，VE和输尿管镜检查未发现异常。
VE作为CT尿路造影的补充手段，对于疑似肿瘤患者上尿路的全面评估应是有用的，可减少纤维输尿管镜检查的必要性。
