原发性输尿管癌的磁共振诊断.docVIP

KKME---专业医学搜索引擎/ 原发性输尿管癌的磁共振诊断 　　作者：郭献日，童婷婷，曹登攀，曹国全 作者单位：温州医学院附属第一医院影像中心，浙江温州 325000 　　【摘要】目的 分析输尿管癌的磁共振成像(MRI)表现，评价MRI对原发性输尿管癌的诊断价值。方法 用1.5T磁共振扫描仪，采用T2加权成像(T2WI)快速自旋回波序列(FSE)、脂肪抑制技术和MR尿路造影(MRU)检查，观察分析21例原发性输尿管癌的MRI表现。结果 21例原发性输尿管癌中，5例表现为输尿管上端结节状病灶，4例表现为输尿管中段结节或条状病灶，12例表现为输尿管下段或下端结节或条状病灶。T1WI为等、略低信号，T2WI为等、高信号，增强扫描有轻、中度强化。MRU显示输尿管截然中断13例，鼠尾状狭窄中断4例，管壁不规则狭窄僵硬4例，与术中所见梗阻部位及程度完全相符。结论 MRI结合MRU能清晰显示输尿管肿瘤的梗阻部位、??阻程度以及累及范围、周围结构情况，选择合理的检查序列加做增强扫描，是诊断输尿管肿瘤的理想方法。 　　【关键词】 输尿管 恶性肿瘤 磁共振成像 　　Diagnostic value of MR in primary ureteral carcinoma 　　Guo Xianri, Tong Tingting, Cao Dengpan, Cao Guoquan 　　(Department of Radiology, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China)ABSTRACT: Objective To analyze the imaging manifestations and to evaluate the diagnostic value of MRI in primary ureteral carcinoma. Methods The MRI manifestations in 21 cases of primary ureteral carcinoma were analyzed retrospectively. T2WI FSE sequence, a fatsuppression T2WI FSE sequence and MR urography (MRU) were performed on all patients. Results 5 lesions located at the upper portion of the ureter showed nodular focus, 4 at the mid portion and 12 at the lower portion showed nodular or strip focus. T1WI manifested isointense or slightly hypointense, while T2WI isointense or hyperintense. The lesions showed mild or moderate enhancement on contrast MRI. On MRU, ureteral abrupt obstruction was found in 13 cases, the narrow mouse caudate interruption in 4 and irregular narrow in 4 cases. The location and degree showed by MRU were well correlated with those observed in surgery. Conclusion Axial T2weighted image combined with MRU can demonstrate accurate level, degree and shape of ureteral obstuction and surrounding structures. It is valuable for detecting and diagnosing primary ureteral carcinoma. 　　KEY WORDS: ureter; malignant tumor; magnetic reasonance imaging 　　原发性输尿管癌是泌尿系统较少见的肿瘤，预后较差且无特异性临床症状，由于位置深，症状隐蔽，使得临床诊断较困难。以往采用X线静脉肾盂造影(IVP)检查，显示率较低，CT和