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影像学检查诊断上尿路移行细胞癌的比较及临床意义(附234例分析)
其他题名Comparison and clinical significance of different imageological methods in the detection of transitional carcinoma of upper urinary tract:Analysis of 234 cases
张骞1; 王秉东1; 王杰平1; 赵亚元1; 孙晓伟1; 郝金瑞1; 何志嵩1
关键词 移行细胞 泌尿道 体层摄影术 螺旋计算机 诊断 Urinary Tract Carcinoma Transitional Cell Diagnosis Tomography Spiral Computed
刊名北京大学学报(医学版)
2009
DOI10.3969/j.issn.1671-167X.2009.06.015
41期:6页:687-690
文章类型Journal Article
摘要目的:比较各种影像学检查对输尿管肿瘤的检出情况,探讨多层螺旋CT泌尿系统成像(MSCTU)在输尿管肿瘤诊断中的优越性.方法:2004年6月至2006年9月手术病理诊断的上尿路移行上皮癌患者234例,其中肾盂癌82例、输尿管癌152例,多数患者行泌尿系B超、静脉尿路造影(IVU)、逆行造影及MSCTU.各项检查的阳性率和符合诊断率的比较采用多重卡方检验.结果:行B超检查者215例,发现异常152例,检查阳性率70.7%,明确诊断58例,符合诊断率为27.0%;行IVU检查者193例,发现异常132例,检查阳性率68.4%,明确诊断65例,符合诊断率33.7%;行逆行造影者132例,发现异常115例,检查阳性率87.1%,明确诊断93例,符合诊断率70.5%;行MSCTU检查者226例,发现异常220例,检查阳性率97.3%,明确诊断214例,符合诊断率94.7%.逆行造影对输尿管肿瘤的符合诊断率显著优于B超和IVU检查(P<0.001),MSCTU的符合诊断率显著优于逆行造影(P<0.001).结论:血尿患者行B超检查后怀疑为上尿路移行细胞癌患者,宜首先考虑行MSCTU检查,以缩短诊断时间并减轻患者痛苦. Objective:To determine the diagnostic value of multislice CT urography (MSCTU) in patients with transitional cell carcinoma ( TCG) of upper urinary tract by comparing other imageology methods used. Methods: Two hundred and thirty four cases of transitional cell carcinoma of upper urinary tract, in which 82 cases were diagnosed pathologically with pelvic carcinoma and 152 cases with ureteral carcinoma, between June 2004 and September 2006 in our institute were enrolled in a retrospective study. Most of them underwent urological ultrasound, intravenous urogram (IVU) , retrograde pyelography and MSCTU. We compared the positive rate (PR) and diagnostic rate (DR) of these methods used by chi-square test. Results: Among the 234 cases, 215 patients underwent urologic ultrasound, in which 152 cases were detected to be abnormal, with the PR of 70.1% ;Meanwhile, 58 cased were diagnosed by this examination, with the DR of 27. 0%. IVU was performed in 193 patients and 132 cases were found to be abnormal, and the PR was 68. 4% , 65 cases were diagnosed by IVU and the DR was 33.7%. And 132 patients underwent retrograde pyelography, by which 115 cases of lesion were detected, with the PR of 87. 1% ; In the meantime, 93 cases were diagnosed, with the DR of 70. 5%.MSCTU was performed in 226 cases and 220 cases were found to be abnormal, and the PR was 97.3% ;214 cases were diagnosed by MSCTU, with the DR of 94. 7%. The DR of detecting TCC of retrograde pyelography had statistically significant difference with that of ultrasound and IVU(P<0.001). As compared with retrograde pyelography, MSCTU had statistically significant superiority (P<0.001). Conclusion: To shorten the diagnosis time and mitigate the sufferings, patients with hematuria supposed to be TCC of upper urinary tract should be recommended to undergo MSCTU first.
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/45624
专题北京大学第一临床医学院_泌尿外科
作者单位1.北京大学第一医院泌尿外科,北京大学泌尿外科研究所,北京,100034
2.辽河油田中心医院泌尿外科
3.大连市第四人民医院外一病房
4.北京大学第一医院影像科
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张骞,王秉东,王杰平,等. 影像学检查诊断上尿路移行细胞癌的比较及临床意义(附234例分析)[J]. 北京大学学报(医学版),2009,41(6):687-690.
APA 张骞.,王秉东.,王杰平.,赵亚元.,孙晓伟.,...&何志嵩.(2009).影像学检查诊断上尿路移行细胞癌的比较及临床意义(附234例分析).北京大学学报(医学版),41(6),687-690.
MLA 张骞,et al."影像学检查诊断上尿路移行细胞癌的比较及临床意义(附234例分析)".北京大学学报(医学版) 41.6(2009):687-690.
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