腺性膀胱炎的影像诊断及病理特征

Imaging diagnosis of cystitis glandularis and its pathological features

目的:探讨腺性膀胱炎的影像诊断要点及相关病理特征。方法:对11例经膀胱镜及病理检查确诊为腺性膀胱炎患者的临床、膀胱镜、MRI、CT及静脉尿路造影(IVU)检查进行回顾性分析。结果:临床表现为血尿5例,尿路刺激症状6例,排尿困难4例,肾功能减退2例;膀胱镜检查10例,表现为菜花样改变5例,水肿与滤泡样改变3例,粘膜粗糙2例。行IVU检查8例,其中6例诊断为膀胱占位,并经CT或MRI检查证实。11例中并发膀胱癌2例,1例多次复发,均经病理证实。结论:腺性膀胱炎病理组织学改变特征是粘膜固有层中存在Brunn′s巢和腺体。MRI、CT检查能发现病变,IVU能发现部分病变,MRI或CT检查发现膀胱占位合并膀胱壁较广泛增厚而无壁外侵犯时,应首先考虑本病。其易与膀胱癌混淆,病理检查是确诊的依据。

Objective： To explore radiographic images diagnostic points of cystitis glandularis （CG） and the interrelated pathologic features. Methods： Their clinical data, cystoscopy, MRI, CT and IVU were analyzed in 11 cases of CG diagnosed by cystoscopy and pathology. Results： Hematuria,Symptoms of Urinary tract irritation, dysuria and renal failure was found in 5 cases, in 6 cases, in 4 cases and 2 cases, respectively. Ten cases were examinated with cystoscopy, 5 cases presenting cauliflower appearance,3 cases edema and follicular configuration and 2 cases roughened mucosa. Eight cases had intravenous urography, among them 6 cases were diagnosed as bladder masses and confirmed by CT or MRI, 2 of 11 had bladder cancer simultaneously, repetitious recurred in 1 cases. All of them were proved by pathological diagnosis. Conclusions： Pathological features of Cystitis glandularis included von Brunn cell nest, glandular metaplasia. MRI, CT and IVU examination can detect these lesions. When the bladder wall becomes diffusely thickened but without surrounding invasion, cystitis glandularis should be firstly diagnosed. Easily mistaken for bladder cancer, it must diagnosis lying in pathology.