Jaeger N, Radeke H W, Vahlensieck W
Z Urol Nephrol. 1985 Jun;78(6):323-9.
With 66.5% the total reliability of the transurethral sonography is significantly higher than that of all methods hitherto used. If one restricts oneself to the differentiation between muscle-invasive and superficial carcinomas the share of impacts is even 77.5%. Considering an error of nevertheless 33% and 23%, respectively, in the T-classification of the carcinoma of the urinary bladder the new method could, however, not fulfil the high expectations which were set into it at the beginning. Particularly a differentiation between mucosa and lamina propria as well as superficial and deep musculature is not possible. According to this the transurethral sonography is not suited as the only method for preoperative T-classification and basis of therapy planning. Difficulties appear above all in large and echo-dense carcinomas, respectively, as well as in pretreated urinary bladders. Consequently, a sufficient experience in the judgment of sonogrammes is necessary, in order to avoid wrong interpretations as to a tumor infiltration. Nevertheless, the transurethral sonography is an essential enlargement of the hitherto scanty spectre of the T-classification of the carcinoma of the urinary bladder. Supplementing the computer tomogram, the method brings the operator a quick survey of a possible infiltration of the wall of the bladder and a perivesical growth of the tumour. In deeply infiltrating, not radically resectable carcinomas in many cases an extensive staging-TUR may thus be avoided.
经尿道超声检查的总可靠性为66.5%，显著高于迄今使用的所有方法。如果仅考虑区分肌层浸润性癌和浅表性癌，其准确率甚至可达77.5%。然而，考虑到在膀胱癌T分期中分别仍有33%和23%的误差，这种新方法无法满足最初对它寄予的厚望。特别是无法区分黏膜和固有层以及浅表和深层肌肉组织。据此，经尿道超声检查不适合作为术前T分期和治疗计划依据的唯一方法。困难尤其出现在体积较大且回声密集的癌肿以及经过预处理的膀胱中。因此，为避免对肿瘤浸润的错误解读，需要操作人员具备足够的超声图像判读经验。尽管如此，经尿道超声检查仍是对迄今膀胱癌T分期方法匮乏的重要补充。该方法与计算机断层扫描相结合，能让操作人员快速了解膀胱壁可能的浸润情况以及肿瘤的膀胱周围生长情况。在许多深度浸润、无法根治性切除的癌肿病例中，这样或许可以避免进行广泛的分期性经尿道膀胱肿瘤切除术。
