儿童嗜酸性膀胱炎的临床及CT表现

Computed Tomography Signs and Clinical Features of Eosinophilic Cystitis in Children

目的探讨儿童嗜酸性膀胱炎(EC)的影像及临床特征。方法回顾性分析本院经病理确诊的5例EC患儿的CT及临床资料。结果 5例中4例CT表现为膀胱壁欠均匀弥漫性增厚并黏膜下宽窄不一低密度水肿带,增强扫描膀胱肌层及黏膜层强化,黏膜线显示完整,水肿带无强化,膀胱壁呈分层样改变,其中1例伴肿块突入膀胱腔内并呈不均匀较明显强化;另1例膀胱壁局部呈肿块样增厚并轻中度强化,膀胱局部周边见少许低密度渗出灶。5例外周血嗜酸性粒细胞比值均有不同程度的增高,3例血清免疫球蛋白E(IgE)水平增高;5例中2例过敏源检测阳性。结论 EC的CT表现具有一定的特征性,结合临床实验室检查及病史,应考虑EC诊断的可能。最终确诊有赖于病理检查。

Objective To explore the imaging and clinical features of eosinophilic cystitis in children. Methods Computed tomography(CT) Signs and clinical features in 5 children with pathology-diagnosed eosinophilic cystitis were retrospectively analyzed. Results On CT scans,4 in 5 cases showed diffuse and irregular thickening of the urinary bladder wall,and uneven low density edematous submucosal zone,bladder muscle and mucosal layers were enhanced and there was preservation of the mucosal line,but the edema zone was not enhanced,with stratified changes of the bladder wall. 1 case had a mass protruding into the bladder lumen and showed inhomogeneous marked enhancement.Localized mass-like thickening of the urinary bladder wall was seen in other cases,and mild to moderate enhancement and also a few low density exudates around the bladder. On laboratory examination,the peripheral eosinophil ratio in all cases increased at different degrees and serum IgE levels increased in 3 cases. Conclusion The CT findings of eosinophilic cystitis have some characteristics,when combined with clinical examination, laboratory examination and medical history,EC diagnosis should be readily made. The final diagnosis depends on pathological examination.