CAJ | 학술논문

目的：探讨原发性输尿管癌与非特异性输尿管炎的 MSCT诊断及鉴别诊断要点。方法回顾性分析经病理证实的12例原发性输尿管癌患者和5例非特异性输尿管炎患者的 MSCT 资料,所有病例均行 MSCT 平扫、3期增强扫描,并采用 MPR、CPR、CTU等技术重建图像,观察两者的 MSCT表现特征。结果①12例原发性输尿管癌病理学诊断均为移行上皮癌,MSCT 表现为9例管壁呈偏心性增厚,其中5例管腔内见软组织肿块,3例管壁呈向心性增厚,病变段管腔明显狭窄,边缘及断端不规则。②非特异性输尿管炎 MSCT表现为1例管壁呈偏心性增厚,3例管壁呈向心性增厚,病变段管腔狭窄,边缘较光整；1例提示肾脏、输尿管积水,病变段输尿管壁尚光整,未见明显增厚。③CT 平扫,原发性输尿管癌和非特异性输尿管炎的密度无统计学差异(P>0.05)；动态增强扫描过程前者强化程度高于后者(P均<0.05)。结论原发性输尿管癌与非特异性输尿管炎均可以不同形式及程度的输尿管壁增厚为主要特征,MSCT增强扫描及 MPR、CPR、CTU 等后处理技术在两者诊断及鉴别诊断方面具有一定的临床应用价值。
목적：탐토원발성수뇨관암여비특이성수뇨관염적 MSCT진단급감별진단요점。방법회고성분석경병리증실적12례원발성수뇨관암환자화5례비특이성수뇨관염환자적 MSCT 자료,소유병례균행 MSCT 평소、3기증강소묘,병채용 MPR、CPR、CTU등기술중건도상,관찰량자적 MSCT표현특정。결과①12례원발성수뇨관암병이학진단균위이행상피암,MSCT 표현위9례관벽정편심성증후,기중5례관강내견연조직종괴,3례관벽정향심성증후,병변단관강명현협착,변연급단단불규칙。②비특이성수뇨관염 MSCT표현위1례관벽정편심성증후,3례관벽정향심성증후,병변단관강협착,변연교광정；1례제시신장、수뇨관적수,병변단수뇨관벽상광정,미견명현증후。③CT 평소,원발성수뇨관암화비특이성수뇨관염적밀도무통계학차이(P>0.05)；동태증강소묘과정전자강화정도고우후자(P균<0.05)。결론원발성수뇨관암여비특이성수뇨관염균가이불동형식급정도적수뇨관벽증후위주요특정,MSCT증강소묘급 MPR、CPR、CTU 등후처리기술재량자진단급감별진단방면구유일정적림상응용개치。
Objective To discuss the MSCT diagnosis and differential diagnosis of primary ureteral carcinoma and non-specific u-reteritis.Methods The pre-contrast and three-phase post-contrast MSCT scans were performed in a group of 12 patients with prima-ry ureteral carcinoma and 5 patients with non-specific ureteritis confirmed by pathology.The MPR,CPR,CTU images were genera-ted from raw data.The MSCT image feature of the primary ureteral carcinoma and non-specific ureteritis were observed respective-ly.Results ①1 2 cases of primary ureteral carcinoma pathologically diagnosed as transitional cell carcinoma,The manifestations of MSCT:9 cases (9/12)showed irregular thickened wall and eccentricity lumen stenosis,5 cases had soft tissue mass in lumen,3 ca-ses (3/12)showed irregular thickened wall and central lumen stenosis.The lesions lumen was significant stenosis,edges and broken ends were irregular.②The non-specific ureteritis manifestations of MSCT:1 case (1/5)showed irregular thickened wall and eccen-trical lumen stenosis;3 cases (3/5)showed irregular thickened wall and central lumen stenosis,and the edge of obstruction was rel-atively smooth.1 case (1/5)prompted hydronephrosis and hydroureter.The lesions lumen was still relatively smooth,had no sig-nificant thickening.③On non-enhanced CT,primary ureteral carcinoma attenuation was equal to the non-specific ureteritis (P>0.05).The degree of enhancement was higher than non-specific ureteritis during all enhanced phases (All P<0.05).Conclusion Main performance characteristics of primary ureteral carcinoma and non-specific ureteritis can both cause the ureteral wall thickening in different appearances and degrees.The MSCT enhanced scan with varies images processing techniques such as MPR,CPR and CTU showed some clinical application potentiality in both diseases diagnosis and discrimination.