Abdominal imaging · 2009
Computerized tomography virtual endoscopy in evaluation of upper urinary tract tumors: initial experience.
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Battista Giuseppe, Sassi Claudia, Schiavina Riccardo, Franceschelli Alessandro, Baglivo Emanuela, Martorana Giuseppe, Canini Romeo
Аннотация
PURPOSE: To assess the usefulness of CT virtual endoscopy (VE) as an integration of CT-urography, for the detection of upper urinary tract tumor in patients with hematuria.
MATERIALS AND METHODS: Fourteen patients with hematuria and high risk of transitional cell carcinoma of the upper urinary tract underwent urinary cytology, ultrasonography, excretory urography, cystoscopy, CT-urography with VE, and optical ureteroscopy. The CT urograms and VE were correlated with the pathological findings of surgical specimen (6/14) and cytological examination of ureteroscopy biopsy (8/14).
RESULTS: VE revealed three renal pelvic and one ureteral tumors, not producing further information did not detected at CT-urography. In two patients VE showed findings strongly indicative of malignancies, not noticed at CT-urography: ureteroscopic biopsy revealed an advanced dysplastic lesion and a malignancy, confirmed at surgery. In one patient VE was questionable (narrowing of the distal ureter) and ureteroscopic biopsy revealed an inflammation. Finally, VE diagnosed a fibrosis of the lumbar ureteral tract, confirmed at ureteroscopic biopsy. In other six patients, VE and ureteroscopy did not find abnormalities.
CONCLUSION: VE should be useful as an integration of CT-urography for a complete evaluation of the upper urinary tract in patients with suspected tumor, limiting the need for fiberoptic ureteroscopic examination.
MATERIALS AND METHODS: Fourteen patients with hematuria and high risk of transitional cell carcinoma of the upper urinary tract underwent urinary cytology, ultrasonography, excretory urography, cystoscopy, CT-urography with VE, and optical ureteroscopy. The CT urograms and VE were correlated with the pathological findings of surgical specimen (6/14) and cytological examination of ureteroscopy biopsy (8/14).
RESULTS: VE revealed three renal pelvic and one ureteral tumors, not producing further information did not detected at CT-urography. In two patients VE showed findings strongly indicative of malignancies, not noticed at CT-urography: ureteroscopic biopsy revealed an advanced dysplastic lesion and a malignancy, confirmed at surgery. In one patient VE was questionable (narrowing of the distal ureter) and ureteroscopic biopsy revealed an inflammation. Finally, VE diagnosed a fibrosis of the lumbar ureteral tract, confirmed at ureteroscopic biopsy. In other six patients, VE and ureteroscopy did not find abnormalities.
CONCLUSION: VE should be useful as an integration of CT-urography for a complete evaluation of the upper urinary tract in patients with suspected tumor, limiting the need for fiberoptic ureteroscopic examination.