Morphology study of ball-shaped bladder tumor on CT and its predictive value of muscle invasion
-
摘要: 目的：探讨CT形态分析对膀胱球形肿瘤肌层浸润情况的预测价值。方法：回顾性分析51例球形膀胱肿瘤行膀胱全切患者的CT资料及病理检查结果，根据瘤体形态进行分析及分类，对照病理结果分析CT瘤体形态与肿瘤肌层浸润情况的关系。结果：球形肿瘤根据CT形态特点可分为五种类型：Ⅰ型24例，为单纯球形（非肌层浸润23例）；Ⅱ型3例，为球形肿瘤周围有低矮片状肿瘤（均非肌层浸润）；Ⅲ型12例，为增强后肿瘤内有焰芯样强化（均非肌层浸润）；Ⅳ型5例，为肿瘤基底处膀胱壁凹陷（肌层浸润3例）；Ⅴ型7例，为伴有同侧输尿管扩张（肌层浸润6例）。本组51例中，根据各型所占例数分析，Ⅰ、Ⅱ、Ⅲ型97.4%（38/39）为非肌层浸润，Ⅳ、Ⅴ型75.0%（9/12）为肌层浸润；如果以此为预测标准，CT对肿瘤肌层浸润情况的判断准确率可达92.2%（47/51）。结论：对于膀胱球形肿瘤，单独通过CT瘤体形态预测判断肿瘤肌层浸润是可行及可靠的。Abstract: Objective: To explore the morphology study of ball-shaped bladder tumor on CT and its predictive value of muscle invasion.Method: CT images and pathology results of patients underwent radical cystectomy were reviewed retrospectively. The bladder tumors were analysed by contour on CT images, based on which a classification was made. Comparison was made between tumor shape modality and histologic examination results to conclude a new method for predicting the aggressiveness of bladder cancers.Result: Round-shaped tumors can be divided into five types by shape on CT:Ⅰ simple round tumor alone, Ⅱ round tumor with thin blanket-shaped tumor around, Ⅲ round tumor with a flame-shaped core enhancement, Ⅳ round tumor with a pit in the bladder wall at tumor base, Ⅴ round tumor with dilation of ipsilateral ureter. Of all the 51 cases enrolled, 97.4% of type Ⅰ, Ⅱand Ⅲ were non-muscle-invasive and 75.0% of type Ⅳ and type Ⅴ were muscle-invasive. The accuracy may achieve 92.2% in differentiating superficial from muscle-invasive tumor by type Ⅰ, Ⅱ, Ⅲ vs. type Ⅳ, Ⅴ.Conclusion: It is feasible and reliable to predict muscle invasion status by tumor shape on CT.
-
Key words:
- bladder tumor /
- CT morphology study /
- muscle invasion
-
-
[1] 张见超,李延江,孙立江,等. 多层螺旋CT对膀胱癌的术前分期价值[J]. 临床军医杂志, 2011, 39(3):447-449.
[2] Miladi M, Peyromaure M, Zerbib M, et al. The value of a second transurethral resection in evaluating patients with bladder tumours[J]. Eur Urol, 2003, 43:241-245.
[3] Mehrsai A, Mansoori D, Taheri Mahmoudi M, et al. A comparison between clinical and pathologic staging in patients with bladder cancer[J]. J Urol, 2004, 1:85-89.
[4] 张振声,蔡小兵,许传亮,等. "超声膀胱软镜"可辅助用于初发膀胱肿瘤术前分期诊断[J]. 第二军医大学学报,2011,32(6):590-594.
[5] 许传亮,张振声,吴承耀,等. "超声膀胱软镜"可辅助用于膀胱占位性病变的术前诊断[J]. 第二军医大学学报,2011,32(6):585-589.
[6] Horiuchi K, Tsuboi N, Shimizu H, et al. High-frequency endoluminal ultrasonography for staing transitional cell carcinoma of the bladder[J]. Urology, 2000, 56:404-407.
[7] Tekes A, Kamel I, Imam K, et al. Dynamic MRI of bladder cancer:evaluation of staing acuracy[J]. AJR Am J Roentgenol, 2005, 184(1):121-127.
[8] Wang D, Zhang W S, Xiong M H, et al. Bladder tumors:dynamic contrast-enhanced axial imaging,multiplanar reformation,three-dementional reconstruction and virtual cystoscopy using helical CT[J]. Chin Med J, 2004, 117:62-66.
[9] 党连荣,王都,谢君伟,等. 多层螺旋CT图像后处理技术在膀胱癌诊断中应用[J]. 中国CT和MRI杂志, 2008, 6(4):76-78.
[10] 孙立辉,郝金钢,黄芩. 多层螺旋CT在膀胱癌术前分期中的应用价值[J]. 昆明医科大学学报, 2012, (5):104-106.
[11] 刘明,闰伟,于京赢,等. CT对膀胱癌局部分期的准确性及影响因素分析[J]. 临床泌尿外科杂志, 2009, 24(6):439-441.
[12] 周小勇,罗良平. 膀胱癌64层CT分期与病理对照分析[J]. 中国CT和MRI杂志, 2012,10(4):74-77.
[13] 文红,明松林,张璇. CT薄层增强扫描对膀胱癌术前分期的价值[J]. 河南科技大学学报(医学版), 2009, 27(2):97-99.
[14] Paik M L, Scolieri M J, Brown S L, et al. Limitations of computerized tomography in staging invasive bladder cancer before radical cystectomy[J]. J Urol, 2000, 163(6):1693-1696.
[15] Kim J K, Park S Y, Ahn H J, et al. Bladder cancer:analysis of multi-detector row helical CT enhancement pattern and accuracy in tumor detection and perivesical staging[J]. Radiology, 2004, 231(3):725-731.
-
计量
- 文章访问数: 128
- PDF下载数: 106
- 施引文献: 0
下载: