Primary ureteral carcinoma: MRI diagnosis and comparison with other diagnostic imaging facilities / 中华放射学杂志

ABSTRACT

Objective To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T2WI (water imaging) was performed to show the dilated ureter, then axial T2WI and T1WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows ultrasound (94. 3% ) , IVU (59. 8% ) , CT (52. 9% ) , MRI (40. 2% ) , and RUP (35. 6% ). The accurate diagnostic rate was as follows MRI (91. 4% ) , RUP (80. 6% ) , CT (63. 0% ) , ultrasound (47. 6% ) , and IVU (11. 5% ). Conclusion Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening.