膀胱尿路上皮癌MR分期及病理对照.docVIP

膀胱尿路上皮癌MR分期及病理对照【摘要】 目的 分析膀胱尿路上皮癌的MR表现及MR分期。方法 回顾性分析27例经手术病理证实的膀胱尿路上皮癌临床表现、MR征象及分期。结果 27例尿路上皮癌MR表现为结节型8例，广基底肿块型15例，浸润型4例，注射Gd-DTPA后，病灶呈轻至中度强化5例，1例无强化。病灶可向腔内或膀胱外生长，累及膀胱周围脂肪及邻近器官和淋巴结转移；T1期3例，T2期4例，T3a期7例，T3b期8例，T4期5例，与病理分期对照，MR分期的准确率为77.8%(21/27) 。结论 MR能够显示膀胱尿路上皮癌特征，对膀胱尿路上皮癌的分期有重要作用。 【关键词】膀胱；肿瘤；尿路上皮癌；磁共振成像 Staging ofurothelial carcinoma with MR correlated with Pathology in bladder GUO Ben-shu，HU Guo-xun，YANG Chang-jun.SectionofMR,Xinyang Center Hospital,Xinyang，Henan 464000,China 【Abstract】 Objective To evaluate the MRI appearances of urothelial carcinoma and the staging by MR in the bladder.Methods 27 cases with surgically and histopathology proved urothelial carcinomawere analyzed retrospectively by MR.Results Themanifestations of urothelial carcinoma on MRI were nodule-type in 8 ; wide-base-mass type in 15; infiltrating type in 4.After injecting Gd-DTPA，the tumors mildly or moderately enhanced in 5，non-enhancement in1,MR could demonstrate clearly the cauliflowerlikeor papillaryform protrudinginto the bladder lumen，or out of vesical wall，Perivesical fat and adjacent structuresand lymph nodes were involved.In 3 patients with T1，In 4 patients with T2，In 7 patients with T3a，In 8 patients with T3b，In 5 patients with T4.Correlated with the staging of urothelial carcinoma by pathology，the accuracy of MR in the stagingurothelial carcinoma was 77.8%(21/27).Conclusion MRI could demonstratefeatures of urothelial carcinoma，and play a important role in the qualitative diagnosis and stagingof urothelial carcinoma. 【Key words】Bladder;Neoplasm;Urothelial carcinoma;Magnetic resonance imaging 尿路上皮癌 (urothelial carcinoma，UC)是泌尿系最常见的恶性肿瘤，约占膀胱癌的90%，正确的治疗依赖于准确的诊断与临床分期，现搜集本院2007年7月至2009年2月间经手术病理证实的尿路上皮癌27例，分析其临床表现、MR影像学特征及病理所见，以提高MR对膀胱尿路上皮癌的诊断水平。 1 资料与方法 1.1 一般资料 本组27例中，男24例，女3例，年龄47~85岁，平均65岁。临床表现：25例有间歇性血尿伴尿频、尿痛及下腹部不适，且4例继发输尿管梗阻扩张，3例无血尿，全部病理均经手术病理证实。 1.2 设备与参数 采用Esicnt Gyrex-privilg 0.5T超导型磁共振扫描仪，选用盆腔线圈，常规行轴位、矢状位、冠状位SE、FSE、STIR序列扫描，T1WI ：TR 400~500 ms、 TE 30