MR urography for suspected upper tract urothelial carcinoma
MR urography for suspected upper tract urothelial carcinoma
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DOI：
10.1007/s00330-008-1228-y
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发表时间：
2009-04-01
影响因子：
5.9
通讯作者：
King, Bernard F.
中科院分区：
文献类型：
--
作者：
Takahashi, Naoki;Kawashima, Akira;King, Bernard F.
对于疑似上尿路尿路上皮癌的磁共振尿路造影方案的关键组成部分是冠状位T2加权水成像序列，没有造影剂和冠状位钆增强T1加权三维扰相梯度回波在肾造影和肾盂造影阶段。上尿路上皮癌根据其生长方式和范围可分为乳头状肿瘤、扁平肿瘤和浸润性肿瘤。乳头状病变在T2加权水像和T1加权肾盂造影时相图像上表现为小的软组织信号充盈缺损。在肾期图像上，病灶呈均匀强化。在肾摄影时相影像上，扁平肿瘤表现为一段的尿路壁弥漫性增厚和强化。浸润性肿瘤常表现为不均匀强化的肿块。在上尿路上皮癌的评估中，MR尿路造影是CT尿路造影的一种有前途的替代方法，特别是当患者有碘化造影剂禁忌症时。
The key components of the MR urography protocol for suspected upper tract urothelial carcinoma are coronal T2-weighted hydrographic sequences without contrast agent and coronal gadolinium-enhanced T1-weighted 3D-spoiled gradient-recalled echo in nephrographic and pyelographic phases. Upper tract urothelial carcinomas can be categorized into papillary tumor, flat tumor, and infiltrative tumor based on the growth pattern and extent. Papillary lesions appear as small filling defects of soft tissue signal on T2-weighted hydrographic and T1-weighted pyelographic phase images. On nephrographic phase images, the lesions show homogeneous enhancement. A flat tumor appears as a segmental area of diffuse thickening and enhancement of the urinary tract wall on nephrographic phase images. Infiltrative tumor often appears as a large heterogeneously enhancing mass. MR urography is a promising alternative for CT urography in the evaluation of upper tract urothelial carcinoma, especially when the patient has a contraindication to iodinated contrast material.