CAJ | 학술논문

目的评价64排螺旋CT(64-MSCT)在小膀胱肿瘤诊断中的应用价值.方法采用64-MSCT对48例小膀胱肿瘤(直径≤1.5 cm)患者进行膀胱轴位平扫、动脉期、静脉期、延迟期增强扫描及图像多平面重建后处理,回顾性分析所获得的CT影像学资料.结果 48例小膀胱肿瘤中,64-MSCT膀胱轴位平扫检出45例,检出率为93.75％,未检出3例,漏检率为6.25％,漏检病灶均＜0.5 cm; 64-MSCT膀胱轴位平扫及动脉期、静脉期、延迟期增强扫描检出48例,检出率为100％.应用多平面重建后处理方法检查,有利于小膀胱肿瘤的定位,48例小膀胱肿瘤中,发生在膀胱壁44例、发生在膀胱憩室内4例.经手术及病理证实,48例小膀胱肿瘤中,膀胱原位癌2例、腺癌6例、移行上皮癌38例、乳头状瘤2例.小膀胱肿瘤的64-MSCT平扫表现为乳头状或菜花样小结节状软组织密度影,增强扫描表现为均匀、持续性强化.6例窄基底的带蒂病灶,64-MSCT均诊断为乳头状瘤,而病理诊断结果为乳头状瘤2例,移行上皮癌4例,64-MSCT误诊率为66.67％,表明64-MSCT对窄基底带蒂病灶的鉴别诊断存在一定难度.64-MSCT对诊断小膀胱肿瘤总的准确率为89.59％,误诊率为10.41％.结论 64-MSCT基本能满足检出、诊断小膀胱肿瘤的要求,是一种无创伤地诊断小膀胱肿瘤较理想的方法.
목적 평개64배라선CT(64-MSCT)재소방광종류진단중적응용개치.방법 채용64-MSCT대48례소방광종류(직경≤1.5 cm)환자진행방광축위평소、동맥기、정맥기、연지기증강소묘급도상다평면중건후처리,회고성분석소획득적CT영상학자료.결과 48례소방광종류중,64-MSCT방광축위평소검출45례,검출솔위93.75％,미검출3례,루검솔위6.25％,루검병조균＜0.5 cm; 64-MSCT방광축위평소급동맥기、정맥기、연지기증강소묘검출48례,검출솔위100％.응용다평면중건후처리방법검사,유리우소방광종류적정위,48례소방광종류중,발생재방광벽44례、발생재방광게실내4례.경수술급병리증실,48례소방광종류중,방광원위암2례、선암6례、이행상피암38례、유두상류2례.소방광종류적64-MSCT평소표현위유두상혹채화양소결절상연조직밀도영,증강소묘표현위균균、지속성강화.6례착기저적대체병조,64-MSCT균진단위유두상류,이병리진단결과위유두상류2례,이행상피암4례,64-MSCT오진솔위66.67％,표명64-MSCT대착기저대체병조적감별진단존재일정난도.64-MSCT대진단소방광종류총적준학솔위89.59％,오진솔위10.41％.결론 64-MSCT기본능만족검출、진단소방광종류적요구,시일충무창상지진단소방광종류교이상적방법.
Objective To evaluate the application value of 64-multi detector spiral CT (64-MSCT)in the diagnosis of small bladder tumor.Metbods Forty-eight patients with small bladder tumor (≤ 1.5 cm) were re-checked by bladder axial scans of 64-MSCT,arterial phase,venous phase,delayed phase enhancement scanning and multi planar reconstruction (MPR) reprocessing.CT imaging data were analyzed retrospectively.Results Among the 48 cases of small bladder tumor,45 cases were detected through bladder axial scans of 64-MSCT,with the positive rate of 93.75％,and 3 cases were not detected,with the miss rate of 6.25％.While 48 cases were detected through bladder axial scans of 64-MSCT,arterial phase,venous phase and delayed enhancement scanning,the positive rate was 100％.The application of MPR reprocessing is favorable to the location of small bladder tumor.Among the 48 cases of small bladder tumor,44 cases occurred on walls of urinary bladders,and 4 cases in vesical diverticulum.All the cases were confirmed by surgery and pathology.Among the 48 cases of small bladder tumour,2 cases were demonstrated as carcinoma in situ,6 cases as adenocarcinoma,38 cases as transitional cell carcinoma,and 2 cases as papillary epithelioma.The signal intensities of small nodular soft tissues with the papillary or cauliflower-like structures were shown by axial scans of 64-MSCT,and uniform and constant reinforcement were appeared in delayed enhancement scanning.Six cases of narrow base pedunculated lesions were diagnosed as papillary epithelioma by 64-MSCT,while 2 cases were confirmed as papillary epithelioma,and 4 cases as transitional cell carcinoma by pathology.Four cases were misdiagnosed by 64-MSCT,with the misdiagnosis rate of 66.67％.There is some difficulty in differential diagnosis of 64-MSCT on narrow base pedunculated lesions.The accuracy rate of diagnosis of small bladder tumor by 64-MSCT was 89.59％,and the rate of misdiagnosis was 10.41％.Conclusion 64-MSCT can meet the needs of detection and diagnosis of small bladder tumor,and may be an ideal method for the non-invasive diagnosis of small bladder tumor.