儿童膀胱横纹肌肉瘤的超声诊断

Diagnosis of bladder rhabdomyosarcoma by ultrasonography in children

目的总结儿童膀胱横纹肌肉瘤超声声像图特点。方法对2006年1月至2017年12月首都医科大学附属北京儿童医院收治并经手术病理检查证实为膀胱横纹肌肉瘤40例患儿的超声声像图特征进行总结。结果 40例患儿(男性27例,女性13例)术前超声均显示膀胱腔内肿物,肿物位于膀胱三角区36例(占90%),非三角区4例(占10%),最小肿物2.6 cm×1.7 cm×2.2 cm,最大肿物6.2 cm×4.4 cm×5.5 cm;36例肿物呈葡萄状或分叶状低回声或等回声包块。与术后病理诊断结果对照,术前超声正确诊断膀胱肿物35例(87.5%)且与病理诊断相符合,其余5例(4例误判为膀胱炎症,1例仅提示膀胱占位性病变)与病理诊断不符合。结论因排尿困难就诊的男性患儿,超声检查发现膀胱三角区肿物,应首先考虑膀胱横纹肌肉瘤。儿童膀胱横纹肌肉瘤超声表现有特异性,是本病首选的检查方法。

Objective To assess the ability of transabdominal ultrasound to detect bladder rhabdomyosarcoma in children and to describe its ultrasonographic appearance. Methods Totally 40 cases of surgically and pathologically confirmed bladder rhabdomyosarcoma cases in Beijing Children′s Hospital Affiliated to Capital Medical University from January 2006 to December 2017 were retrospectively reviewed and the ultrasonographic characteristics were analyzed. Results In 40 patients, the ultrasound made correct diagnosis in 35 cases. In 40 cases, the bladder rhabdomyosarcoma showed intravesical mass. Tumors are commonly located at the vesical trigone and bladder neck, appeared as a botryoid or lobulated, hypoechoic or isoechoic mass. Conclusions The diagnosis of bladder rhabdomyosarcoma should be considered in case with a mass at the vesical trigone by ultrasonography, especially for boys with difficulty in urination. Due to the specific ultrasonic manifestations of bladder rhabdomyosarcoma in children, ultrasound examination can be used as the first choice of diagnostic imaging.