目的 探讨静脉肾盂造影与多层 螺旋CT(MSCT)扫描对膀胱癌的诊断价值。 方法 回顾性分析2015年8月至2018年5月 于我院就诊治疗的82例膀胱癌患者的临 床病例及影像学资料，根据资料可知所有 患者入院均后均行静脉肾盂造影和MSCT检 查，分析膀胱癌在不同检查方法中的影 像学特征，并总结和比较不同检查方法 对膀胱癌的诊断正确率。结果 82例膀胱 癌患者共有病灶154个，静脉肾盂造影病 灶检出率为80.52%，MSCT病灶检出率为 97.40%；静脉肾盂造影对膀胱癌的正确诊 断率为67.44%，而MSCT对膀胱癌的正确诊 断率为93.02%，即MSCT对膀胱癌的检出 及诊断率均显著高于静脉肾盂造影检查 (P<0.05)。在MSCT平扫中，膀胱癌患者其 膀胱多表现为充盈较差，膀胱壁不规则增 厚，部分患者在膀胱壁局部可见肿块影和 部分高密度影，进一步增强扫描可示肿块 在其动脉期表现为轻度强化，在静脉期和 延迟期呈现为持续性轻度强化；在静脉肾 盂造影检查中，主要显示肾盏、肾盂和输 尿管情况，可表现为无异常、盏杯口消 失、肾盂积水、扩张等，对于胱充盈欠佳 和充盈缺损也可一定显示。结论 较静脉 肾盂造影而言，MSCT检查对膀胱癌的检出 及诊断率均明显较高，具有更好的扫描效 果和定位诊断性，可更清晰的显示膀胱癌 病灶的组织学结构，进而更有利的为临床 治疗提供有力证据。

Objective To investigate the diagnostic value of intravenous pyelography and multi-slice spiral CT (MSCT) scanning for bladder cancer. Methods The clinical data and imaging of 82 patients with bladder cancer who were treated in our hospital from August 2015 to May 2018 were retrospectively analyzed. According to the data, all patients underwent intravenous pyelography and MSCT after admission. The imaging features of bladder cancer in different examination were analyzed, and the diagnostic accuracy of different examination for bladder cancer was summarized and compared. Results 82 patients with bladder cancer had 154 lesions in total, the detection rate of lesions by intravenous pyelography was 80.52%, the detection rate of lesions by MSCT was 97.40%, the correct diagnosis rate of bladder pyelography for bladder cancer was 67.44%, while the correct diagnosis rate of MSCT for bladder cancer is 93.02%.That is, the detection and diagnosis rate of bladder cancer by MSCT was significantly higher than that by intravenous pyelography (P<0.05). In the MSCT plain scan, patients with bladder cancer have a poor filling of bladder and thickening of the irregular bladder wall. In some patients, a mass shadow and a part of high-density shadow were observed in the bladder wall.Further enhancement of the scan showed that the mass had mild enhancement in the arterial phase, and persistent mild enhancement in the venous phase and the delayed phase. In the venous pyelography, the renal pelvis, renal pelvis and ureter are mainly shown, which can be shown with normalities, disappearance of the cup of the pelvis, hydronephrosis, expansion, etc., and poor filling of cyst and filling defects can also be shown. Conclusion Compared with intravenous pyelography, the detection and diagnosis rate of bladder cancer by MSCT is significantly higher, with better scanning effect and localization of diagnosis. It can more clearly show the histological structure of lesionsof bladder cancer, and thus is more favorable to provide strong evidence for clinical treatment.