【摘要】 目的　探讨早期 ( 0～Ⅱ级 )原发性肾盂盏移行细胞癌CT征象及其与肿瘤分期的相关性。方法　回顾性分析由手术、病理证实 ,且曾作螺旋CT扫描的早期原发性肾盂盏移行细胞癌 19例。观察分析其CT征象并对肿瘤进行CT分期 ,再与手术、病理结果进行对照。结果　CT显示腔内肿块 19例 ,其定性诊断的正确率为 10 0 % ( 19/19例 ) ,对肿瘤分期总的正确率为 78.95 % ( 15 /19例 )。主要征象包括 :肾窦脂肪环绕征的出现率为 2 6.3 2 % ( 5 /19例 ) ,准确分期率为 10 0 % ( 5 /5例 ) ;肾窦脂肪消失征的出现率为 3 1.5 8% ( 6/19例 ) ,准确分期率为 66.67% ( 4 /6例 ) ;肿瘤近端积水征的出现率为 2 .11% ( 8/19例 ) ,准确分期率为 75 .0 0 % ( 6/8例 ) ;肾实质局部低灌注征的出现率为 6.84% ( 7/19例 ) ,准确分期率为 42 .86% ( 3 /7)。结论　肾窦脂肪环绕征为肿瘤分期的可靠征象 ,其余征象则存在过高分期的现象。CT在早期肾盂盏移行细胞癌的检出及定性诊断方面具有较高的临床价值。对有典型早期表现的肿瘤可作出正确的分期诊断 ,但对各种情况引起的肾实质灌注降低尤其是各种征象合并存在时易将早期肿瘤列入进展期的行列更多还原

【Abstract】 Objective To investigate the CT features and the relationship between CT Features and tumor staging in early stage transitional cell carcinomas of the renal pelvic calices. Methods Spiral CT images of 19 consecutive patients with early renal pelvic caliceal transitional cell carcinoma were evaluated. Tumor staging was made according to the CT features, and then compared with the operative and pathologic results.Results 19 tumors were seen as intraluminal sessile masses involving the calyces in 10, the renal pelvis in 9. The total accurate diagnosed rate of CT was 100%(19/19) and the total accurate rate of staging by CT was 78.9%(15/19). The main CT features were: central masses surrounded by renal sinusoidal fat, the visualization rate was 26.32%(5/19),accurate staging 100%; with disappearance of the renal sinusoidal fat, the visualization rate was 31.58%(6/19),accurate staging 66.67%(4/6); Hydronephrosis proximal to the pelvic mass: the visualization rate was 42.11%(8/19), accurate staging 75%(6/8); Inadequate sufficient perfusion of renal parenchyma: the visualization rate was 36.84%(7/19), accurate staging 42.86%(3/7).Conclusion The sign of masses surrounding by renal sinusoidal fat usually suggests an early tumor. While presence of other signs at the sametime, oftentime leads to the diagnosis of advanced stage tumor.更多还原