Raman Siva P, Horton Karen M, Fishman Elliot K
Department of Radiology, Johns Hopkins University, JHOC 3251, 601 N. Caroline Street, Baltimore, MD 21287, USA.
Abdom Imaging. 2012 Dec;37(6):1129-40. doi: 10.1007/s00261-011-9838-2.
This article reviews the pathophysiology of transitional cell carcinoma (TCC), CT urography (CTU) protocols, different possible 3D reconstruction techniques, and the importance of 3D reconstructions for appropriate interpretation.
RESULTS/CONCLUSION: CTU has largely replaced conventional IV pyelography in the evaluation of the upper urinary tract for TCC. The majority of large lesions can be easily seen on standard axial images with multiplanar reformats. However, it is imperative to also use 3D reconstructions when interpreting these studies, as subtle lesions can be difficult to visualize on the more traditional images. In this pictorial essay, we present multiple cases of upper urinary tract TCC which illustrate the value of 3D reconstructions for increasing the conspicuity of lesions, particularly at the junction of the infundibulum and calyx and in the ureters. As these cases demonstrate, each of the three possible 3D reconstruction techniques (maximum intensity projection, volume rendering, and volume rendered "virtual ureteroscopy") has its own distinct advantages, although the pitfalls of each technique must also be kept in mind.
本文综述移行细胞癌（TCC）的病理生理学、CT尿路造影（CTU）方案、不同的三维重建技术以及三维重建对于准确解读的重要性。
结果/结论：在评估上尿路TCC时，CTU已在很大程度上取代了传统静脉肾盂造影。大多数大的病变在标准轴位图像及多平面重组图像上很容易看到。然而，在解读这些检查时，使用三维重建也很有必要，因为细微病变在更传统的图像上可能难以显示。在这篇图文并茂的文章中，我们展示了多例上尿路TCC病例，这些病例说明了三维重建对于提高病变的显见度的价值，尤其是在肾小盏漏斗部与肾小盏交界处及输尿管处。正如这些病例所示，三种可能的三维重建技术（最大密度投影、容积再现及容积再现“虚拟输尿管镜检查”）各有其独特优势，不过每种技术的缺陷也必须牢记。
