二维超声和CT对膀胱癌术前分期的价值

目的：探讨二维超声与CT扫描对膀胱癌分期诊断的临床价值及临床检查方法的选择。方法：搜集经病理确诊，且术前均行超声及CT检查的膀胱癌患者45例，将患者分为2组，即T1-T3a期组和T3b—T4期组，比较超声及CT与各组临床分期的符合率，并用统计学方法处理其结果。结果：45例患者中，T1-T3a期31例，T3b—T4期14例；超声对T1-T3a期病变分期的符合率（77．4％）较CT（66．7％）高。但两组比较差异无统计学意义（P=0．39〉0．05），CT对T3a-T4期病变分期的符合率（92．9％）较超声（50．0％）高，且差异有明显的统计学意义（P=0．03〈0．05）。结论：二维超声和CT检查对膀胱癌的检出及分期是互补的方法，超声对浸润较浅的病变分期较敏感，而CT检查对T3b期及其以上膀胱癌分期较敏感。综合利用二者对膀胱癌分期可以指导临床选择恰当的治疗方式。

Comparison the value of tumor staging for bladder cancer between CT and ultrasonography before operation

Aim: To compare the tumor staging for bladder cancer between CT and ultrasonography before operation,and discuss which is the more accurate method.Methods: 45 patients with primary bladder cancer were studied by spiral CT and ultrosonography before the operation.Patients were assigned to two stage groups: stage T1-T3a,stage T3b-T4,compare the accuracy of CT and ultrasonography staging with the postoperative staging.Results: Postoperative staging showed 31 patients belong to the first group,CT identified 21 patients of them with an accuracy of 66.7% and ultrasound identified 24 patients with an accuracy of 77.4%,the difference between the two accuracies was not statistically significant.Postoperative staging showed 14 patients belong to second group,CT identified 13 patients of them with an accuracy of 92.9% and US identified 7 patients with an accuracy of 50.0%,the difference between the two accuracies was statistically significant.Conclusion: Ultrasonography is the more accurate method in staging the T1-T3a group bladder cancer,CT is the more accurate method in staging the T3b-T4 group bladder cancer.They are complementary methods in evaluation of T stages of primary bladder cancer,and can guide the treatment together.