Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, USA.
Clin Radiol. 2010 Mar;65(3):185-92. doi: 10.1016/j.crad.2009.11.003. Epub 2009 Dec 14.
To evaluate the diagnostic performance of magnetic resonance urography (MRU) versus retrograde pyelography and/or ureteroscopy (RPU) in the detection of upper urinary tract neoplasms.
This retrospective study included 35 patients with suspected upper urinary tract malignancy who underwent MRU and RPU within 6-months in our institution during the study period (February 2002 to January 2007). MRU and RPU reports were reviewed and results recorded. For each patient, the urinary tract was sub-divided into four regions for analysis: left kidney/renal pelvis, left ureter, right kidney/renal pelvis, and right ureter. MRU and RPU results for each patient were compared to a reference standard and the diagnostic performance of both techniques was compared.
A total of 113 regions were analysed on MRU and 90 regions on RPU. Nineteen neoplasms were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for the detection of urinary tract neoplasms were 63, 91, 60, and 92% for MRU, respectively, and 53, 97, 83, and 88% for RPU, respectively. These differences were not statistically significant (p>0.05).
The high negative predictive value of MRU in the present series supports its use as a non-invasive screening examination for excluding the presence of upper urinary tract malignancy.
评估磁共振尿路成像（MRU）与逆行肾盂造影和/或输尿管镜检查（RPU）在上尿路肿瘤诊断中的表现。
本回顾性研究纳入了 35 名在研究期间（2002 年 2 月至 2007 年 1 月）于我院接受 MRU 和 RPU 检查的疑似上尿路恶性肿瘤患者。回顾分析了 MRU 和 RPU 报告并记录了结果。对每位患者，将尿路分为四个区域进行分析：左肾/肾盂、左输尿管、右肾/肾盂和右输尿管。将每位患者的 MRU 和 RPU 结果与参考标准进行比较，并对两种技术的诊断性能进行了比较。
MRU 共分析了 113 个区域，RPU 分析了 90 个区域。共发现 19 个肿瘤。MRU 检测尿路肿瘤的灵敏度、特异度、阳性预测值和阴性预测值分别为 63%、91%、60%和 92%，RPU 分别为 53%、97%、83%和 88%。这些差异无统计学意义（p>0.05）。
本系列研究中 MRU 的高阴性预测值支持其作为一种非侵入性的筛选检查方法，用于排除上尿路恶性肿瘤的存在。
