膀胱内翻性乳头状瘤的MSCT表现及与尿路上皮乳头状癌的鉴别

发布时间：2018-03-06 17:16

本文选题：体层摄影术　切入点：X线计算机　出处：《临床放射学杂志》2015年04期 　论文类型：期刊论文

【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(P0.05),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(P0.05),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。
[Abstract]:Objective to investigate the MSCT features of inverted papilloma of the bladder (IPB) and its value in differential diagnosis between IPB and urothelial papillary carcinoma. Methods the MSCT findings of 14 cases of IPB and 25 cases of urothelial papillary carcinoma confirmed by surgery and pathology were retrospectively analyzed. Results in 14 cases of IPB, 10 cases were located in trigonometric area and 4 cases were located in lateral wall. Among the 5 cases with local bladder wall thickening, 13 cases with papillary papillary carcinoma, 1 case with cauliflower type, 25 cases with urothelial papillary carcinoma, 6 cases were located in trigonometry and 19 cases were located in the parietal lateral wall. Of 18 cases with local bladder wall thickening, 10 cases presented papillary papillary lesion and 15 cases presented rapeseed shape. IPB and the ratio of the longest diameter to the base width of the lesion protruding into the lumen of papillary carcinoma were 2.164 卤0.761U 0.747 卤0.196, respectively. The enhancement values of the two types were 25.357 卤17.376HUU 37.400 卤14.705, respectively. 41.680 卤17.264HUA and 39.360 卤22.038HU in the delayed period, respectively. There were significant differences in the location of the lesion and the shape of the lesion between the two groups (P 0.05, P 0.027), but there was no difference between the venous phase and the delayed phase (P 0.027). There was a statistical significance (P 0.05), but the enhancement degree of IPB increased gradually. Conclusion IPB is usually located in the triangle region, with narrow basement connected to the bladder wall, the thickening bladder wall is not enhanced, the longest diameter of the lesion is obviously larger than the width diameter of the basal base, and the degree of enhancement is the highest in the venous phase and the delayed phase is decreased in the papillary carcinoma. The enhancement degree of the third stage was gradually increased, but relatively weak, and the above imaging features were helpful to differentiate it from the epithelial papillary carcinoma of the urinary tract.
【作者单位】：苏州大学附属第二医院影像科;
【分类号】：R737.14;R730.44

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