左开荣 陈力 李伦成 李政雄 代红 周艺 刘元兵

[摘要]目的 探討多层螺旋CT尿路成像与CT血管造影（MSCTU+CTA）在泌尿系恶性肿瘤诊断中的应用价值。方法 选取2014年1月～2019年9月在我院同时接受MSCTU+CTA和B超（US）检查的55例泌尿系恶性肿瘤患者为研究对象，回顾性分析其影像学表现，以手术病理结果为标准评价两组检查的诊断效能。结果 55例泌尿系恶性肿瘤患者中，肾癌18例，肾盂癌3例，输尿管癌2例，膀胱癌32例。US检查正确诊断42例，误诊8例，漏诊5例，定位诊断准确率为90.90%（50/55），定性诊断准确率为76.36%（42/55）;MSCTU+CTA正确诊断50例，误诊3例，漏诊2例，定位诊断准确率为96.36%（53/55），定性诊断准确率为90.90%（50/55）。MSCTU+CTA的定性诊断准确率明显高于US，差异有统计学意义（P<0.05）。结论 MSCTU+CTA和US是泌尿系恶性肿瘤的重要检查手段，MSCTU+CTA在定性诊断准确率方面优于US，具有重要临床应用价值。

[关键词]多层螺旋CT;CT尿路成像;CT血管造影;恶性肿瘤;泌尿系;诊断;应用价值

[中图分类号] R737.1          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0165-04

Application value of MSCTU+CTA in the diagnosis of urological malignant tumor

ZUO Kai-rong1   CHEN Li1   LI Lun-cheng1   LI Zheng-xiong1   DAI Hong1   ZHOU Yi1   LIU Yuan-bin2▲

1. Department of Radiology， the Second People′s Hospital of Jiangjin District in Chongqing City， Chongqing   402289， China; 2. Department of Radiology， the People′s Hospital of Qijiang District in Chongqing City， Chongqing   401420， China

[Abstract] Objctive To investigate the aoolication value of multi-slice spiral computed tomography urography and computed tomography angiography （MSCTU+CTA） in the diagnosis of urological malignant tumor. Methods A total of 55 participants with urological malignant tumor who were examined by MSCTU + CTA and ultrasound （US） in our hospital from January 2014 to September 2019 were selected as the study objects. Imaging was analyzed retrospectively， and the diagnostic efficacy of the two groups was evaluated according to the surgical and pathological results. Results Within the 55 malignant tumor， there were 18 cases with renal cell carcinomas， 3 cases with renal pelvic cancer， 2 cases with ureteral cancer， and 32 cases with bladder cancer. A total of 42 cases were diagnosed correctly， 8 cases were misdiagnosed， and 5 cases were missed by US， the accuracy of location diagnosis was 90.90% （50/55）， and that of qualitative diagnosis was 76.36% （42/55）. As for MSCTU+CTA， there were 50 cases diagnosed correctly， 3 cases were misdiagnosed and 2 cases were missed， the accuracy of location diagnosis was 96.36% （53/55）， and that of qualitative diagnosis was 90.90% （50/55）. The diagnostic accuracy of MSCTA+CTU was significantly higher than US， and the difference was statistically significant （P<0.05）. Conclusion Both MSCTU+CTA and US play important role in the diagnosis of urological malignant tumor. MSCTU+CTA is better than US in diagnostic accuracy and has significant value for clinical application.

[Key words] Multi-slice spiral computed tomography; Computed tomography urography; Computed tomography angiography; Malignant tumor; Urinary system; Diagnosis; Application value

泌尿系恶性肿瘤是指发生于泌尿系统任意部位的恶性肿瘤，主要包括肾、肾盂、输尿管、膀胱和尿道恶性肿瘤，多好发于40岁以上的人群，且男性多于女性，临床以膀胱癌发病率最高，其次为肾癌、肾盂癌[1]。近年来，泌尿系恶性肿瘤发生率有所上升，呈现出逐年升高的趋势，及时准确的术前诊断在临床工作中具有重要意义。对于泌尿系恶性肿瘤患者，现有检查方法包括磁共振（magnetic resonance imaging，MRI）、超声检查（ultrasound，US）、静脉肾盂造影（intravenous pyelography，IVP）、逆行肾盂造影（retrograde pyelography）、尿路平片（KUB）以及CT检查[2]等，其中多层螺旋CT具有多层面成像、分辨率高、立体感强、扫描范围大，能够全方位、多角度显示泌尿系恶性肿瘤的全部影像特征。本研究旨在探讨多层螺旋CT尿路成像与CT血管造影（MSCTU+CTA）在泌尿系统恶性肿瘤诊断中的应用价值，现报道如下。……