现代泌尿生殖肿瘤杂志
現代泌尿生殖腫瘤雜誌
현대비뇨생식종류잡지
JOURNAL OF CONTEMPORARY UROLOGIC AND REPRODUCTIVE ONCOLOGY
2014年
4期
217-220,227
,共5页
膀胱肿瘤%多层螺旋 CT%仿真内镜%诊断
膀胱腫瘤%多層螺鏇 CT%倣真內鏡%診斷
방광종류%다층라선 CT%방진내경%진단
Urinary bladder neoplasms%Multi-slice spiral computer%Virtual endoscopy%Diagnosis
目的：探讨多层螺旋 CT 仿真膀胱镜(multi-slice spiral CT virtual cystoscopy,MSCTVC)对膀胱癌术前诊断及临床分期的价值。方法22例经手术病理证实为膀胱癌的患者,术前分别行MSCT 双期增强扫描,同时结合仿真内镜图像进行分析及普通纤维膀胱镜检查,比较两种方法的膀胱癌检出率,分析 MSCTVC 对膀胱癌术前分期的准确性。结果22例患者共发现病灶25个, MSCT 及 MSCTVC 总体检出率为100%(25/25),高于膀胱镜检查(92%,23/25)。单纯双期增强MSCT 分期：T113例、T2a 5例、T2b 5例、T31例、T41例；结合仿真膀胱镜成像后分期：T113例、T2a 4例、T2b 5例、T32例、T41例；术后病理分期：pTl 13例、pT2a 5例、pT2b 4例、pT32例、pT41例。MSCT 多期增强扫描对膀胱癌术前分期总体准确率为72%(18/25),结合仿真膀胱镜成像对膀胱癌分期总体准确率为88%(22/25)。与术后病理分期相比,MSCTVC 对膀胱癌术前分期的一致性(k=0.818)高于 MSCT 扫描术前分期一致性(k=0.574)。尤其当肿瘤浸润膀胱壁外结构时(≥T3期)时,MSCTVC 的术前分期准确率为100%,与术后病理分期完全一致(k =1)。结论MSCTVC 是一种安全、无创、有效的检查方法,在膀胱癌术前诊断及临床分期中具有重要价值。
目的：探討多層螺鏇 CT 倣真膀胱鏡(multi-slice spiral CT virtual cystoscopy,MSCTVC)對膀胱癌術前診斷及臨床分期的價值。方法22例經手術病理證實為膀胱癌的患者,術前分彆行MSCT 雙期增彊掃描,同時結閤倣真內鏡圖像進行分析及普通纖維膀胱鏡檢查,比較兩種方法的膀胱癌檢齣率,分析 MSCTVC 對膀胱癌術前分期的準確性。結果22例患者共髮現病竈25箇, MSCT 及 MSCTVC 總體檢齣率為100%(25/25),高于膀胱鏡檢查(92%,23/25)。單純雙期增彊MSCT 分期：T113例、T2a 5例、T2b 5例、T31例、T41例；結閤倣真膀胱鏡成像後分期：T113例、T2a 4例、T2b 5例、T32例、T41例；術後病理分期：pTl 13例、pT2a 5例、pT2b 4例、pT32例、pT41例。MSCT 多期增彊掃描對膀胱癌術前分期總體準確率為72%(18/25),結閤倣真膀胱鏡成像對膀胱癌分期總體準確率為88%(22/25)。與術後病理分期相比,MSCTVC 對膀胱癌術前分期的一緻性(k=0.818)高于 MSCT 掃描術前分期一緻性(k=0.574)。尤其噹腫瘤浸潤膀胱壁外結構時(≥T3期)時,MSCTVC 的術前分期準確率為100%,與術後病理分期完全一緻(k =1)。結論MSCTVC 是一種安全、無創、有效的檢查方法,在膀胱癌術前診斷及臨床分期中具有重要價值。
목적：탐토다층라선 CT 방진방광경(multi-slice spiral CT virtual cystoscopy,MSCTVC)대방광암술전진단급림상분기적개치。방법22례경수술병리증실위방광암적환자,술전분별행MSCT 쌍기증강소묘,동시결합방진내경도상진행분석급보통섬유방광경검사,비교량충방법적방광암검출솔,분석 MSCTVC 대방광암술전분기적준학성。결과22례환자공발현병조25개, MSCT 급 MSCTVC 총체검출솔위100%(25/25),고우방광경검사(92%,23/25)。단순쌍기증강MSCT 분기：T113례、T2a 5례、T2b 5례、T31례、T41례；결합방진방광경성상후분기：T113례、T2a 4례、T2b 5례、T32례、T41례；술후병리분기：pTl 13례、pT2a 5례、pT2b 4례、pT32례、pT41례。MSCT 다기증강소묘대방광암술전분기총체준학솔위72%(18/25),결합방진방광경성상대방광암분기총체준학솔위88%(22/25)。여술후병리분기상비,MSCTVC 대방광암술전분기적일치성(k=0.818)고우 MSCT 소묘술전분기일치성(k=0.574)。우기당종류침윤방광벽외결구시(≥T3기)시,MSCTVC 적술전분기준학솔위100%,여술후병리분기완전일치(k =1)。결론MSCTVC 시일충안전、무창、유효적검사방법,재방광암술전진단급림상분기중구유중요개치。
Objective To discuss the value of double-phase enhancement multi-slice spiral CT and virtual cystoscopy (MSCTVC)using oxygen as contrast in the diagnosis and clinical staging of preoperative bladder cancer. Methods Twenty two patients with bladder cancer diagnosed by oper-ation.All of them were examined both by double-phase enhancement and virtual cystoscopy using oxygen as contrast and conventional cystoscopy.The sensitivity of the diagnosis and the accuracy of the clinical staging of preoperative bladder cancer were compared. Results There were 25 lesions to be found.The sensitivity of MSCT and MSCTVC was 100% (25/25),that is higher than the sen-sitivity of the conventional cystoscopy.The staging of MSCT:Tl 13 cases,T2a 5 cases,T2b 5 cases, T3 1 case,T4 1 case.The staging of MSCTVC using oxygen:Tl 13 cases,T2a 4 cases,T2b 5 cases, T3 2 cases,T4 1 case.Histopathological results:pTl 13 cases,pT2a 5 cases,pT2b 4 cases,pT3 4 ca-ses,pT4 1 case.The sensitivity of preoperative staging on bladder cancer was 72% (18/25 )by double-phase enhancement of MSCT.When double-phase enhancement and virtual images using oxy-gen were evaluated together,the sensitivity rate increased to 88% (22/25 ).The concordance of MSCTVC in clinical staging of preoperative bladder cancer was higher than MSCT alone.Especially, when the tumors had invaded the tissues and organs beyond the bladder wall (≥T3 ),the accuracy was 100%,and the concordance was coincident completely (k= 1 ). Conclusions Double-phase enhancement and virtual cystoscopy using oxygen of MSCT is a safe,noninvasive and effective meth-od,and it is of great value in the diagnosis and clinical staging of preoperative bladder cancer.
