摘要
目的探讨膀胱内翻性乳头状瘤(IPB)的MSCT表现特点及其与尿路上皮乳头状癌的鉴别诊断价值。方法回顾性分析经手术病理证实的14例IPB及25例尿路上皮乳头状癌患者的MSCT表现,比较两者的发病部位、病灶形态及强化程度,并进行统计学检验。结果 14例IPB中10例位于三角区,4例位于侧壁,伴局部膀胱壁增厚者5例;13例呈乳头状,1例呈菜花状。25例尿路上皮乳头状癌中6例位于三角区,19例位于顶侧壁,伴局部膀胱壁增厚者18例;10例呈乳头状,15例呈菜花状。IPB和乳头状癌病灶向腔内突出的最长径与基底部宽径之比分别为2.164±0.761、0.747±0.196;两者强化值为:动脉期分别为(25.357±17.376)HU、(37.400±14.705)HU,静脉期分别为(34.143±22.055)HU、(41.680±17.264)HU,延迟期分别为(42.357±12.701)HU、(39.360±22.038)HU。两者发病部位和病灶形态比较差异具有统计学意义(P<0.05),两者动脉期强化程度比较差异具有统计学意义(P=0.027),静脉期和延迟期强化程度比较差异无统计学意义(P>0.05),但IPB强化程度呈逐渐升高趋势,而乳头状癌静脉期强化程度最高,延迟期减低。结论 IPB多位于三角区,呈乳头状,窄基底与膀胱壁相连;增厚膀胱壁无明显强化;病灶最长径明显大于基底部宽径;三期强化程度呈逐渐升高趋势,但相对较弱。上述影像特点有助于与尿路上皮乳头状癌相鉴别。
Objective To analyze the multi-slice spiral CT （MSCT） features of inverted papilloma of bladder （IPB） and to discuss the differentiation of IPB from epithelial papillary carcinoma of urinary tract in order to improve its diagnostic accuracy. Methods A total of 14 patients with IPB and 25 patients with epithelial papillary carcinoma of urinary tract were enrolled in this study. The diagnosis was confirmed by pathology in all patients. MSCT findings, including location, shape and enhancement degree, were retrospectively analyzed. The results were statistically evaluated. Results Of the 14 patients with IPB, the lesion was located at the trigone area in 10 and at the lateral wall in 4; thickened local bladder wall was seen in 5. The lesion was papillary in shape in 13 patients and cauliflower in shape in one patient. Of the 25 patients with epithelial papillary carcinoma of urinary tract, the lesion was located at the trigone area in 6 and at upper-lateral wall in 19; thickened local bladder wall was seen in 18. The lesion was papillary-shaped in 10 patients and cauliflower- shaped in 15 patients. The average ratios of the longest diameter to the widest base diameter of tumor protruding into the bladder cavity in IPB and in epithelial papillary carcinoma were 2. 164 ±0. 761 and 0.747 ±0. 196 respectively, and their enhanced CT values were （25. 357± 17. 376） HU and （37. 400 ±14.705 ） HU respectively in arterial phase, （34. 143 ±22. 055 ） HU and （41. 680 ±17. 264） HU respectively in venous phase, and （42. 357 ± 12. 701 ） HU and （39. 360 ± 22. 038） HU respectively in delayed phase. The differences in the lesion＇ s location and morphology between the two groups were statistically significant （ P 〈 0.05 ） ; the difference in the lesion＇ s enhancement degree in arterial phase was also statistically significant （ P 〈 0.05 ） ; while the differences in the lesion＇ s enhancement degree in both venous phase and delayed phase were not statistically significant （ P 〉
出处
《临床放射学杂志》
CSCD
北大核心
2015年第4期586-590,共5页
Journal of Clinical Radiology
