Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Johns Hopkins University, 601 N. Caroline Street/JHOC 3235A, Baltimore, MD, 21287, USA.
Abdom Radiol (NY). 2019 Dec;44(12):3874-3885. doi: 10.1007/s00261-019-02173-2.
Urothelial carcinoma of the upper urinary tract (UUT) is a relatively uncommon genitourinary malignancy, accounting for about 5-7% of urothelial tumors. The significant features of this tumor are multifocality and high rate of recurrence. Computed tomography urography (CTU) has replaced excretory urography (EU) and retrograde pyelography (RP) for imaging of upper tract urothelial carcinoma. While many studies have confirmed high sensitivity (88-100%) and specificity (93-100%) of CTU, an optimized CT protocol is of critical importance in screening, staging, and post-operative follow-up of patients (Chlapoutakis, Eur J Radiol 73(2):334-338, 2010; Caoli and Cohan, Abdom Radiol (NY) 41(6):1100-1107, 2016). The key element of the CT protocol is to have adequate distension of the collecting system with excreted contrast, to detect subtle lesions at an early stage. In this article, we discuss the background of upper urinary tract TTC, pathogenesis, CT protocol and the role of imaging in evaluation of this malignancy, staging, as well as different imaging appearances.
上尿路尿路上皮癌（UUT）是一种相对罕见的泌尿生殖系统恶性肿瘤，约占尿路上皮肿瘤的 5-7%。该肿瘤的显著特征是多灶性和高复发率。计算机断层尿路造影（CTU）已取代排泄性尿路造影（EU）和逆行肾盂造影（RP），成为上尿路尿路上皮癌的影像学检查方法。虽然许多研究已经证实 CTU 具有很高的敏感性（88-100%）和特异性（93-100%），但优化的 CT 方案对于筛查、分期和患者术后随访至关重要（Chlapoutakis，Eur J Radiol 73（2）：334-338，2010；Caoli 和 Cohan，Abdom Radiol（NY）41（6）：1100-1107，2016）。CT 方案的关键要素是使集合系统充分扩张并排出对比剂，以便早期发现细微病变。在本文中，我们讨论了上尿路 TTC 的背景、发病机制、CT 方案以及影像学在评估这种恶性肿瘤、分期以及不同影像学表现中的作用。
