彩色多普勒超声对腺性膀胱炎的鉴别诊断价值

The differential diagnostic value of color Doppler ultrasonography in cystitis glandularis

目的探讨彩色多普勒超声检查对腺性膀胱炎的鉴别诊断价值。方法采用彩色多普勒超声检查39例腺性膀胱炎和192例膀胱癌患者，观察膀胱病变的位置、形态、边界、内部回声及其与膀胱壁的关系，并检查病变内部的血流分布，将其声像图表现进行对比分析。超声检查结果与膀胱镜活检或手术病理结果对照。结果59．0％（23／39）腺性膀胱炎和52．9％（74／14（1）的单发膀胱癌病灶位于膀胱三角区及输尿管口周围；53．8％（21／39）的腺性膀胱炎表现为膀胱壁局限性增厚，72．9％（140／192）的膀胱癌为单发结节或团块，两者的病灶形态分布差异有统计学意义（P〈0.01）；69．2％（27／39）的腺性膀胱炎病灶内部见囊状无回声区，而膀胱癌病变内均未见此声像改变；膀胱癌病灶边缘见点状强回声者占48．4％（93／192），而腺性膀胱炎仅为7．7％（3／39），二者差异有统计学意义（P〈f）．01）；彩色多普勒显示84．9％（163／i92）膀胱癌病变内检出血流信号，其血流检出率明显高于腺性膀胱炎。彩色多普勒超声对腺性膀胱炎与膀胱癌的诊断准确率分别为84．6％（33／39）、95．3％（183／192）。结论彩色多普勒超声检查能清晰显示腺性膀胱炎的位置、边界、形态、内部回声及其与膀胱壁的关系，对腺性膀胱炎的鉴别诊断和临床随访有重要作用。

Objective To probe the differential diagnostic value of color Doppler nltrasonography（CDU） in cystitis glandularis. Methods Thirty nine cystitis glandularis and 192 bladder cancer were examined with CDU. The location, shape, boundary,internal echo and relationship with wall of urinary bladder of lesion were observed. Internal blood flow disposition of lesion were detection. The results of CDU were compared with those of clstoscope biopsy and pathologic diagnosis after operation. Results 59. （）% （23/39） cystitis glandularis and 52.9% （74/140） bladder cancer lesions located in t rigone of bladder and surrounded the orifice of ureter. 53.8 % （21/39） cystitis glandularis showed part wall thickening and 72.9% （]40/192） bladder cancer showed single nodus or bolus. Sacculiform anechoic area were observed in 69.2 % （27/39） cystitis glandularis and were not observed in bladder cancer. Punctiform hyperechogenicity appeared in periphery of 48.4 % （93/192） bladder cancer and 7.7 （3/39） cystitis glandularis. The detection rate of interior blood flow signal of bladder cancer was 84. 9% （ 163/ 192） ,which was obviously higher than that of cystitis glandularis. The diagnostic accurate rates of CDU in cystitis glandularis and bladder cancer were 84.6% （33/39） and 95.3% （ 183/192）, respectively. Conclusions CDU can clear display the location, shape, boundary, internal echo and relationship with wall of urinary bladder of cystitis glandularis and is of important value in diagnosis, differential diagnosis and clinical fllow-up of cystitis glandularis.