[Value of radiologic examinations in the diagnosis and staging of upper urinary tract tumors].
From 1980 to 1991, 109 patients were treated for a tumour of the upper urinary tract. All patients were examined by intravenous urography (IVU) which had a sensitivity of 61%. The combination of IVU + RUP established the diagnosis in 72% of cases. Renal ultrasonography and abdominal computed tomography (CT) were performed in 41 and 67 cases, respectively. The sensitivity of ultrasonography was 40% and that of CT was 72%. CT was more sensitive for tumours of the renal pelvis (78%) than for ureteric tumours (53%) (p < 0.02) and when the tumour diameter exceeded 2 cm (70% vs 45%: p < 0.01). The sensitivity of CT for lymph node extension was 47% with an accuracy of 88%. Preoperative CT staging was compared to pathological staging: CT staging had an accuracy of 56%; in 31% of cases, CT underestimated the parietal extension of the tumour. The sensitivity of CT to assess invasion of the renal parenchyma and of the perirenal fat was 52% and 74%, respectively (p < 0.01). Morphological examinations are able to diagnose a tumour of the upper urinary tract in 3 out of 4 cases. Correct preoperative staging can only be achieved on one half of cases, which constitutes a drawback to the development of conservative treatment techniques.
Bretheau
D
D
Service de Chirurgie Urologique et Transplantation Rénale, Hôpital Salvator, Marseille.
Lechevallier
E
E
Uzan
E
E
Rampal
M
M
Coulange
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002295:Carcinoma, Transitional Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014516:Ureteral Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014567:Urography / Q000379:methods
Valeur des examens radiologiques dans le diagnostic et la stadification des tumeurs de la voie excrétric urinaire supérieure.