Puech P, Rouprêt M, Renard-Penna R, Lemaître L, Colin P
Service de radiologie, CHRU de Lille, université Lille Nord de France, 59000 Lille, France.
Service d'urologie, hôpital de la Pitié-Salpêtrière, 75013 Paris, France; GRC5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, AP-HP, 75005 Paris, France.
Prog Urol. 2014 Nov;24(15):987-99. doi: 10.1016/j.purol.2014.07.009. Epub 2014 Sep 12.
To propose a state of the art regarding imaging techniques for the diagnosis and work-up of upper tract urothelial carcinoma (UTUC).
A systematic review of the scientific literature was performed in the Medline database (PubMed) until 2014 using different associations of the following keywords: urothelial carcinomas; upper urinary tract; ureter; renal pelvis; CT scan; MRI; ultrasound; urography.
Imaging has a prominent role in the diagnosis, extension and follow-up assessment of upper tract urothelial cancers (UTUC). The couple ultrasound/intravenous urography made way for the multidetector computed tomography urography (MDCTU) and for the magnetic resonance imaging urography (MRU), which can also be combined in some cases. This review of the literature presents available techniques for the exploration of the upper urinary tract, the main protocols (in particular the interest of furosemide addition), details the interpretation techniques for searching UTUC on serial imaging, as well as the main differential diagnoses, and their accuracy. Finally, the role of imaging, according to patient's context is discussed. The combination or fusion of different modalities (CT, MR…) for the same objective is highlighted and presented as the likely evolution of UTUC imaging.
MDCTU is nowadays the gold standard imaging modality for the diagnosis of UTUC.
提出有关上尿路尿路上皮癌（UTUC）诊断及检查的成像技术的最新进展。
截至2014年，在Medline数据库（PubMed）中对科学文献进行系统综述，使用以下关键词的不同组合：尿路上皮癌；上尿路；输尿管；肾盂；CT扫描；MRI；超声；尿路造影。
成像在上尿路尿路上皮癌（UTUC）的诊断、分期及随访评估中发挥着重要作用。超声/静脉尿路造影已被多排螺旋CT尿路造影（MDCTU）和磁共振成像尿路造影（MRU）所取代，在某些情况下两者也可联合使用。本文献综述介绍了用于上尿路检查的现有技术、主要方案（特别是加用呋塞米的意义），详细阐述了在系列成像中搜索UTUC的解读技术，以及主要鉴别诊断及其准确性。最后，根据患者情况讨论了成像的作用。强调并展示了针对同一目的不同模式（CT、MR等）的联合或融合，这可能是UTUC成像的发展方向。
如今MDCTU是诊断UTUC的金标准成像模式。
