膀胱平滑肌瘤的超声声像图特征

Ultrasonic features of bladder leiomyoma

目的探讨膀胱平滑肌瘤的超声声像图特征。方法回顾性分析经手术病理确诊的7例膀胱平滑肌瘤患者的超声表现。结果 7例膀胱平滑肌瘤常规超声显示均是单发肿块,平均最大直径(3.47±1.42)cm。6例肿块位于膀胱壁黏膜下,且凸向膀胱腔内生长;1例肿块位于膀胱浆膜下与子宫之间,突向膀胱外生长。所有肿块二维超声均表现为低回声,回声均匀,且肿块基底部较宽;位于黏膜下者其表面膀胱壁黏膜层光滑完整、与周围的黏膜面连续,呈线状强回声;6例肿块表现为边界清楚,形态规则,1例表现为边界欠清,形态欠规则;CDFI示4例肿块内有点状血流信号,3例未见明显血流信号。结论膀胱平滑肌瘤多发生于女性患者,于二维超声图像常表现为膀胱后壁黏膜下单发的边界清楚、形态规则的均质低回声团块,基底部较宽,团块内可有点状血流信号,术前诊断有时较困难,必要时仍需结合膀胱镜检查及病理活检以明确诊断。

Objective To investigate the sonographic features of bladder leiomyoma.Methods The sonographic features on seven patients with bladder leiomyomas confirmed by pathology were retrospectively analyzed.Results All 7patients showed one single bladder leiomyoma,with an average diameter of（3.47±1.42）cm.Six of the tumors located at the submucosa of bladder wall,and grew toward to the bladder lumen;the other one located between the subserosa of bladder and uterus,which grew towards outsider of the bladder.On the two-dimensional ultrasound images,all leiomyomas were hypoechoic with homogeneous echogenicity and wide bases.The surface mucous layers of tumors located at the submucosa of bladder smoothly extended to the surrounding mucosae,and displayed linear hyperechoic.Six masses illustrated well-defined boundaries and regular shapes,while the rest mass had an ill-defined boundary and an irregular shape.In CDFI,4tumors presented dotted blood flow signals,the rest 3tumors had no obvious blood flow signal.Conclusion Bladder leiomyoma is more common on females.It is usually single developed on the posterior wall of bladder,and with wide base,well-defined border,regular shape,homogeneous hypoechoic,smooth mucous surface layer of bladder,and dotted blood flow signal on ultrasound images.However,the preoperative diagnosis via imaging techniques is sometimes difficult,and cystoscopy and（or）pathological biopsy are required for correct diagnosis.