CAJ | 학술논문

目的：探讨双源CT尿路成像（CTU）在上尿路肿瘤诊断中的临床应用价值。方法对30例拟诊断为上尿路肿瘤的患者行双源螺旋CT尿路成像重建，三维后处理技术主要包括：多平面重建（MPR）、最大密度投影（MIP）和容积重建（VRT）、曲面重建（CPR）等。结果21例患者经双源CT尿路成像诊断为尿路肿瘤（17例输尿管癌、4例肾盂移行上皮癌），17例输尿管癌患者肿瘤位于右侧输尿管8例，左侧输尿管的9例；输尿管上段6例，中段5例，下段6例。21例患者管壁不规则增厚、管腔弥漫性狭窄5例，管腔偏心性肿块2例，输尿管呈软组织密度影、管腔消失14例。全部病例均行肾、输尿管加袖套状膀胱部分切除术，术后经病理证实为上尿路上皮肿瘤。双源CT尿路成像诊断准确率为100%。结论双源CT上尿路成像能多平面、多方位地显示肿瘤，再结合轴位动态增强图像，对于原发性输尿管癌及肾盂移行上皮癌的诊断具有极高的应用价值。
목적：탐토쌍원CT뇨로성상（CTU）재상뇨로종류진단중적림상응용개치。방법대30례의진단위상뇨로종류적환자행쌍원라선CT뇨로성상중건，삼유후처리기술주요포괄：다평면중건（MPR）、최대밀도투영（MIP）화용적중건（VRT）、곡면중건（CPR）등。결과21례환자경쌍원CT뇨로성상진단위뇨로종류（17례수뇨관암、4례신우이행상피암），17례수뇨관암환자종류위우우측수뇨관8례，좌측수뇨관적9례；수뇨관상단6례，중단5례，하단6례。21례환자관벽불규칙증후、관강미만성협착5례，관강편심성종괴2례，수뇨관정연조직밀도영、관강소실14례。전부병례균행신、수뇨관가수투상방광부분절제술，술후경병리증실위상뇨로상피종류。쌍원CT뇨로성상진단준학솔위100%。결론쌍원CT상뇨로성상능다평면、다방위지현시종류，재결합축위동태증강도상，대우원발성수뇨관암급신우이행상피암적진단구유겁고적응용개치。
Objective To evaluate the value of dual-source CT urography in the diagnosis of upper urinary tract tumors (UUTT). Methods Thirty patients with suspected UUTT underwent dual-source CT urography. Three-dimensional post-processing techniques included multiplanar reconstruction (MPR), maximum-intensity projection (MIP),volume rendering technique (VRT) and curved planar reconstruction (CPR). Results Among the 30 patients,dual-source CT urography showed urinary tract tumors in 21 (ureter cancer in 17 and transitional cell carcinoma of the renal pelvis in 4). Among the 17 patients with ureter cancer,tumors were located in the right ureter in 8,in the left ureter in 9,in the upper ureter in 6,in the middle ureter in 5, and in the lower ureter in 6. Among the 21 patients with urinary tract tumors,irregular ureteral wall thickening with diffuse luminal stenosis was found in 5,luminal eccentric masses in 2,and soft tissue density shadow with luminal disappearance in 14. All patients underwent partial resection of kidney and ureter and sleeve cystectomy,and were confirmed as having upper urinary tract urothelial tumors by postoperative pathological examination. The diagnostic accuracy was 100%. Conclusion Dual-source CT urography can multi-planarly and multi-directionally display tumors. The combination of dual-source CT urography and axial dynamic contrast-enhanced scan is of great value in the diagnosis of primary ureteral carcinoma and transitional cell carcinoma of the renal pelvis.