泌生系统疾病CT诊断.ppt

独肾 左肾缺如，左肾窝由小肠充填，右肾代偿性肥大，皮质增厚 马蹄肾 两肾下极相互融合如马蹄状，肾轴向异常，肾盂位于前方、肾盏指向后方 膀胱结石 膀胱癌 CT延迟扫描，膀胱右后壁肿块形成充盈缺损 肾上腺转移瘤 双侧肾上腺圆形肿块，密度均匀，边缘光滑，边界清楚 * Figure 27-4 Superficial papillary transitional cell carcinoma. A, Axial endorectal surface-coil fast spin-echo 5000/144 image shows a polypoid mass of the right posterior bladder wall (black arrows). A central fibrous core is seen (thin white arrow). The soft tissue that is anterolateral to the mass represents another polypoid lesion (seen better on adjacent sections). B, Dynamic gadolinium diethylene-triamine-pentaacetic acid-enhanced T1-weighted gradient-echo 68/4.3/60 image shows enhancement of the peripheral portion of the lesion. The fibrous core and underlying detrusor muscle do not enhance. Superficial papillary cancer was removed at cystoscopy hours after imaging. C, Delayed T1-weighed, fat-suppressed, gradient-echo 200/2.9/90 image, shows delayed enhancement of the fibrous core (thin black arrow) and subjacent detrusor muscle. Delayed detrusor enhancement is nonspecific and cannot be used to diagnose infiltration by cancer. * Figure 24-4 Cushings adenoma. A, In-phase axial FMP-SPGR 45/4.2/60 image shows intermediate signal intensity (143, arbitrary scale) in the right adrenal mass (arrow) B, Out-of-phase axial FMP-SPGR 45/3.1/60 image shows reduction in signal intensity (94, same scale as A,) in the right adrenal mass, confirming the presence of lipid. (Courtesy E. Siegelman.) * Figure 24-7 Pheochromocytoma. A, CT scan in patient with episodic hypertension. There is a small right adrenal mass (arrow) that has a nonspecific appearance. Note clip artifacts. B, T2-weighted image. Right adrenal mass has extremely high signal intensity, which is typical of most pheochromocytomas. * CT（Computed Tomography） 膀胱结石 膀胱腔内单发或多发致密影，即使阴性结石密度也显著高于其他病变 变化体位扫描病灶位置发生改变 增强扫描可显示阴性结石 * 膀胱乳头状癌 膀胱造影（Cystography） 大小不等，形态不规则的充盈缺损 乳头状瘤（Papilloma）体积较小、有蒂、表面光滑 乳头状癌（Papillary Carcinoma ）形态不规则，基底部较宽，表面凹凸不平呈菜花状，侵犯肌层时，局部膀胱壁僵硬 非乳头状癌（Non-P