膀胱血管瘤的超声表现、临床及病理特征

UItrasound findings clinical presentation and pathological features of bladder hemangioma

目的总结膀胱血管瘤患者临床、超声及病理特征。方法对6例北京协和医院2002年6月至2015年7月临床收治并经手术病理检查证实为膀胱血管瘤患者的临床、病理及术前超声声像图特征进行总结分析。结果 6例膀胱血管瘤患者临床表现为全程血尿4例,尿频、尿急、尿痛或间断尿痛各1例。术前超声显示6例膀胱病灶均表现为低回声,5例病灶内见小无回声区呈＂筛孔状＂结构;病灶最大径0.5~4.1 cm;其中4例病灶位于膀胱三角区,1例位于膀胱左前壁（单发4例、多发1例）,1例膀胱壁弥漫性增厚伴壁内多发病灶;彩色多普勒血流成像（CDFI）示1例病灶血流信号丰富,1例病灶少量血流信号,4例病灶未见明确血流信号。病理诊断：膀胱血管瘤合并慢性炎症3例,膀胱海绵状血管瘤1例、膀胱肌间血管瘤1例,膀胱血管瘤伴部分血管壁黏液变性1例。结论膀胱区低回声病灶内见多个小无回声区呈＂筛孔状＂为膀胱血管瘤典型超声图像特征,结合患者血尿、尿频、排尿困难等临床表现有助于术前超声诊断。

Objective To evaluate the ultrasound findings, clinical presentation and pathological features of bladder hemangioma. Methods Between 2002 and 2015, 6 patients had histologically confirmed bladder hemangioma in Peking Union Medical College Hospital. The ultrasound findings, clinical presentations and pathological features of the 6 patients were evaluated. Results Of the 6 bladder hemangioma, 3 cases were associated with chronic inflammation, 1 was cavernous hemangioma, 1 was muscular hemagioma and 1 was bladder hemangioma with partial blood vessel wall degeneration. Of all these 6 cases, 4 cases were solitary nodule, 1 case was multiple nodules located at the trigone and the top of the bladder and 1 case was diffuse thickening of bladder wall with multiple nodules. The mean maximum diameter of bladder hemangioma was（0.5-4.1 cm）. The 6 bladder hemangioma cases were all hypoechoic on ultrasound. Multiple small anechoic areas within the lesion were seen in 5 cases and abundant blood flow signals were shown in 5 cases. On color Doppler ultrasound, abundant, moderate and no blood fiow signals were shown in 1, 1and 4 cases, respectively. Conclusion The characteristics of the ultrasound findings of bladder hemangioma were hypoechoic nodule with multiple small anechoic areas within the lesion, which is helpful for diagnosis in combination with the patient？s clinical presentation such as hematuria, frequent micturition and dysuria.