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Transitional Cell Carcinoma Involving the Distal Ureter

Assessment With Transrectal and Color Doppler Ultrasonography

Departments of Diagnostic Radiology (H.J.K., J.W.L., D.H.L., Y.T.K., J.H.O.) and Pathology (Y.W.K.), Kyung Hee University Hospital, Seoul, Korea.

Address correspondence to Joo Won Lim, MD, Department of Diagnostic Radiology, Kyung Hee University Hospital, 1 Hoegi-dong, Dongdaemungu, Seoul 130-702, Korea. E-mail: uroradiolim{at}dreamwiz.com

Objective. The purpose of this study was to compare the feasibility of transrectal ultrasonography (TRUS) and color Doppler ultrasonography (CDUS) with transabdominal ultrasonography (TAUS) for the diagnosis of transitional cell carcinoma (TCC) involving the distal ureter. Methods. Our study group consisted of 12 patients having TCC involving the distal ureter who had undergone TAUS and TRUS. Verification of the TCC involving the distal ureter was made by surgery (n = 9) or urine cytologic examination combined with the imaging findings (n = 3). The gray scale images of TAUS and TRUS were retrospectively evaluated to determine whether the ureteral mass was visualized. The CDUS findings were compared with the T stage, the histopathologic grade, and the mean microvessel density of histopathologically proved distal ureteral TCCs (n = 8). Results. Transabdominal ultrasonography showed hypoechoic ureteral dilatation in 6 patients, a ureteral mass in 5, and anechoic ureteral dilatation in 1. Transrectal ultrasonography showed a ureteral mass in all 12 patients. Color Doppler ultrasonography could show blood flow in the ureteral mass in all patients. The tumor vascularity on CDUS showed no statistically significant relationship with the T stage, the histopathologic grade, and the mean microvessel density. Conclusions. Compared with TAUS, TRUS seems to improve the ability to detect TCC involving the distal ureter. In conjunction with TRUS, CDUS shows blood flow in the ureteral mass, and this may be helpful for the diagnosis of TCC involving the distal ureter.

Key Words: color Doppler imaging • neoplasms • ultrasonography • ureter

Abbreviations: CDUS, color Doppler ultrasonography • CT, computed tomography • MRI, magnetic resonance imaging • TCC, transitional cell carcinoma • TAUS, transabdominal ultrasonography • TRUS, transrectal ultrasonography

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