Computertomographie bei Nierenbeckenkarzinom

Abstract

The value of computer tomography in the investigation of carcinomas of the renal pelvis was analysed in 22 patients. In 88% of cases it was possible to differentiate tumours confined to stages I and II from tumours in the advanced stages III and IV. Computer tomographic signs of stages III and IV were demonstration of infiltration into the surrounding tissues and into the renal parenchyma as well as the presence of regional lymph node metastases. Computer tomography should follow urography wherever there is a suspicion of a pelvic carcinoma in order to define the tumour more precisely.

CT of Carcinoma of the Renal Pelvis

“…Nonvisualization on a urogram may occur in 30 to 50% of the cases (39% in the present series), while the corresponding figures for CT have been reported to range from 0 to 20Y0 (2,7,12,15,25). According to the primary CT reports in our series, 18% of the tumors were missed and in retrospect 14%.…”

“…CT does not seem to offer any advantages relative to retrograde pyelography in the visualization of renal pelvic tumors according to our experience and that of others (2,25). In addition, retrograde pyelography is probably more advantageous in detecting multiple tumors, especially small ones, due to superior spatial resolution.…”

“…~I L L E R et al (25) found a positive correlation in all 4 of their patients with such a finding. Our patient with negative correlation had been subjected to percutaneous nephrostomy.…”

“…Renal infiltration was verified in all 9 tumors with such a CT finding in the present series, in 6 of 7 pelvic tumors in the series of BARON et al (2), and in 10 of 12 tumors in the series of T~L L E R et al (25). The fakepositive interpretations were due to pyelonephritic changes indistinguishable from tumor infiltration in one instance (2), whereas the tumor was probably only abutting the renal parenchyma in 2 instances (25). We also had 6 tumors abutting normal renal parenchyma at CT but only 2 of them had microscopic evidence of peripelvic tumor extension.…”

“…The experience of CT in evaluating patients with renal pelvic carcinoma appears to be limited (1,2,7,12,25) and in only 2 reports (2,25) has there been any systematic correlation between CT and histopathologic classification.…”