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目的 :探讨CT仿真膀胱镜检查(CTVE)和CT动态增强扫描(DCECT)对膀胱恶性肿瘤诊断价值的比较。方法:选择2012—2014年本院收治的疑似膀胱疾病患者123例,对比DCECT和CTVE对膀胱恶性肿瘤诊断的准确度、特异度、灵敏度和分期准确性。结果:经CT和病理学诊断有47例确诊为患有膀胱恶性肿瘤,共检出61个病灶,病灶大小0.2 cm×0.3 cm~4.1cm×5.4 cm。CTVE和DCECT的灵敏度、准确度和特异度分别为91.5%、94.3%、96.0%和89.4%、92.7%、94.7%,差异不具有统计学意义(P>0.05)。DCECT和CTVE对于T1~T3a的检出率分别为67.5%和80.0%,两者具有较为显著差异(χ2=7.547,P=0.006)。两种方法对T3b~T4的检出率都为87.5%(P>0.05)。结论:CTVE与DCECT在膀胱恶性肿瘤诊断价值上各有利弊,联合CTVE与DCECT对膀胱病变进行检查,可以得到较为全面的诊断信息,具有较好的临床应用价值。
Objective: To compare the diagnostic value of CT virtual cystoscopy (CTVE) and dynamic contrast-enhanced CT (DCECT) in bladder cancer. Methods: 123 cases of suspected bladder diseases admitted to our hospital from 2012 to 2014 were selected to compare the accuracy, specificity, sensitivity and staging accuracy of DCECT and CTVE in the diagnosis of bladder cancer. Results: Of the 47 cases diagnosed as having bladder cancer by CT and pathology, 61 lesions were detected. The size of the lesion was 0.2 cm × 0.3 cm ~ 4.1 cm × 5.4 cm. The sensitivity, accuracy and specificity of CTVE and DCECT were 91.5%, 94.3%, 96.0% and 89.4%, 92.7% and 94.7% respectively, with no significant difference (P> 0.05). The positive rates of DCECT and CTVE for T1 ~ T3a were 67.5% and 80.0%, respectively (χ2 = 7.547, P = 0.006). The detection rates of T3b ~ T4 by both methods were 87.5% (P> 0.05). Conclusion: Both CTVE and DCECT have their own advantages and disadvantages in the diagnosis of bladder cancer. Combined with CTVE and DCECT, bladder lesions can be examined and more comprehensive diagnostic information can be obtained, which has a good clinical value.