膀胱副神经节瘤影像学表现

Imaging manifestations of paraganglioma of urinary bladder

目的观察膀胱副神经节瘤(PUB)影像学表现。方法回顾性分析经手术病理证实的9例单发PUB患者资料,其中8例接受腹部超声、6例接受盆腔CT、6例接受盆腔MR检查,观察其影像学表现。结果9个PUB病灶均呈类圆形或椭圆形,宽基底,边界清楚,形态规则,直径14~41 mm,平均(27.3±9.1)mm;位于膀胱左侧壁2个、左前壁1个、右侧壁2个、右前壁4个。二维超声显示8个(8/8,100%)病灶均呈低回声,其中6个(6/8,75.00%)可见“膀胱黏膜线”征;CDFI显示6个(6/8,75.00%)病灶血流信号丰富,1个(1/8,12.50%)可见点、条状血流信号,1个(1/8,12.50%)无血流信号。CT显示6个(6/6,100%)病灶均呈软组织密度,其中1个(1/6,16.67%)见瘤内囊变、坏死;2个(2/6,33.33%)见“膀胱黏膜线”征。MRI显示6个病灶(6/6,100%)均位于膀胱黏膜下,“膀胱黏膜线”征均清晰可见,4个(4/6,66,67%)呈T1WI稍高信号、1个(1/6,16.67%)呈稍低信号、1个(1/6,16.67%)呈等信号,脂肪抑制T2WI 5个(5/6,83.33%)呈稍高信号、1个(1/6,16.67%)呈等信号,弥散加权成像5个(5/6,83.33%)呈高信号、1个(1/6,16.67%)呈稍高信号。增强CT及MRI病灶均见明显强化(6/6,100%)。结论PUB影像学表现具有一定特征性,有助于诊断。

Objective To observe the imaging manifestations of paraganglioma of urinary bladder(PUB).Methods Data of 9 patients with single PUB confirmed by surgical pathology were retrospectively analyzed.Among 9 cases,8 cases underwent abdominal ultrasonography,6 underwent pelvic CT and 6 underwent pelvic MR examination.The imaging manifestations of PUB were observed.Results All 9 PUB lesions shaped round or ellipsoid,with wide base,clear boundary and regular shape,the diameters were 14—41 mm,with an average of(27.3±9.1)mm.Two lesions located at the left lateral wall,1 at the left anterior wall,2 at the right lateral wall and 4 at the right anterior wall of the bladder.Two dimensional ultrasound displayed hypoechoic lesions in all 8 cases(8/8,100%),and“bladder mucosa line”sign was detected in 6 cases(6/8,75.00%),while CDFI showed rich blood flow signals in 6 lesions(6/8,75.00%),spot and strip blood flow signal in 1 lesion(1/8,12.50%)but no blood flow signal in 1 case(1/8,12.50%).CT showed that all 6 lesions(6/6,100%)present as soft tissue densities,1(1/6,16.67%)with intratumoral cystic change and necrosis,while“bladder mucosa line”sign was found in 2 cases(2/6,33.33%).MRI showed all 6 lesions(6/6,100%)located under the bladder mucosa,and“bladder mucosa line”sign was clearly visible(6/6,100%).Four lesions(4/6,66.67%)present as slight hyperintensities,1(1/6,16.67%)as slight hypointensity and 1 as isointense(1/6,16.67%)on T1WI,5(5/6,83.33%)as slight hyperintensity(n=5)and 1 as isointense(1/6,16.67%)on fat suppression-T2WI,5(5/6,83.33%)as high signals but 1(1/6,16.67%)as slightly hyperintensity on diffusion weighted imaging.Significant enhancements of lesions(6/6,100%)were noticed on both enhanced CT and MRI.Conclusion The imaging manifestations of PUB had certain characteristics,which were helpful to diagnosis.