摘要
目的:探讨膀胱副神经节瘤的CT及磁共振成像(magnetic resonance imaging,MRI)特征,提高对膀胱副神经节瘤诊断的准确率。方法:回顾并分析2002年7月-2015年10月中山大学附属第一医院及中山市中医院(广州中医药大学附属中山医院)手术后病理学检查证实的14例膀胱副神经节瘤患者的临床及影像学资料,其中10例行盆腔CT平扫加增强扫描,4例行盆腔MRI平扫加增强扫描及扩散加权成像(diffusion-weighted imaging,DWI),回顾并分析其影像学特征。结果:14例患者中女性10例,男性4例。病灶均为单发,最大径9~50 mm,表现为主体位于膀胱壁内的、向膀胱腔内或外生长的肿物,分别位于膀胱前壁(1例)、后壁(1例)、左侧壁(4例)、右侧壁(4例)、顶壁(1例)和下壁(3例)。14例中2例为恶性,其中1例肿瘤侵犯同侧髂内动脉分支,1例术后20个月发生左侧盆腔淋巴结及肺内转移。14例中12例为功能性膀胱副神经节瘤,24 h尿香草扁桃酸(vanillylmandelic acid,VMA)不同程度升高,其中9例有典型临床表现(排尿时伴发阵发性高血压),3例出现高血压;2例非功能性膀胱副神经节瘤无明显临床症状。10例CT平扫结果显示为均匀等密度,无囊变或出血、钙化,增强扫描后2例明显均匀强化,8例不均匀强化,较大肿瘤边缘可见显著强化,静脉期强化较动脉期轻度降低。MRI图像上,4例肿瘤T1WI呈较均匀高信号,T2WI高信号,1例较大肿瘤可见出血。增强扫描肿瘤明显均匀强化,DWI示肿瘤呈均匀或不均匀高信号,表观扩散系数(apparent diffusion coefficient,ADC)图为低信号。结论:膀胱副神经节瘤的影像学表现具有一定特点,结合临床症状、实验室检查可以作出准确的诊断。
Objective:To explore the CT and magnetic resonance imaging(MRI)features of the paraganglioma of the urinary bladder in order to improve diagnosis accuracy.Methods:The clinical and radiologic data of 14 cases with pathologically proved paraganglioma of the urinary bladder which were selected from the archives of Hospital of Traditional Medicine of Zhongshan and the First Affiliated Hospital of Sun Yat-sen University from Jul.2002 to Oct.2015 were retrospectively analyzed.Pelvis CT scanning with contrast-enhancement were performed in 10 cases,pelvis MRI scanning with contrast-enhancement and diffusionweighted imaging(DWI)were employed in 4 cases.The imaging features of these cases were retrospectively analyzed.Results:The 14 patients included 10 women and 4 men.All lesions were solitary,the maximum diameter ranged from 9 to 50 mm.All lesions appear as a mass within the urinary bladder wall,with intravesical or extravesical growth.The locations of the lesions were as follows:anterior wall(n=1),posterior wall(n=1),left wall(n=4),right wall(n=4),superior wall(n=1),and inferior wall(n=3).Two of the 14 cases were malignant,with one case the tumor invaded the branch of ipsilateral internal iliac artery,and another case presented with metastases of left pelvic lymph nodes and lung at the twenty months after surgical resection of the tumor.Twelve of the 14 cases were functional paraganglioma,with a varying degree of elevation of a 24-hour urine vanillylmandelic acid(VMA).Among the 12 cases,nine cases typically present with paroxysmal hypertension precipitated by voiding,the other 3 cases present with hypertension.Two of the 14 cases were nonfunctional paraganglioma with no symptoms.Ten cases displayed homogeneous iso-intense density with no cystic degeneration,hemorrhage,or calcification occurs at nonenhanced CT.On contrast enhanced CT scan,two cases showed uniform obviously enhanced,and 8 cases demonstrated ununiform enhancement.At MRI imaging,all the 4 cases showed homogenous slightly hyperintense on T1WI,hyperintense on
作者
刘锋
肖煦阳
王焕军
方字文
余水全
李水连
刘树学
LIU Feng;XIAO Xuyang;WANG Huanjun;FANG Ziwen;YU Shuiquan;LI Shuilian;LIU Shuxue(Department of Radiology,Hospital of Traditional Medicine of Zhongshan,Zhongshan 528400,Guangdong Province,China;Department of Radiology,First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,Guangdong Province,China)
出处
《肿瘤影像学》
2020年第2期181-186,共6页
Oncoradiology
关键词
膀胱肿瘤
副神经节瘤
体层摄影术
X线计算机
磁共振成像
Urinary bladder tumor
Paraganglioma
Tomography
X-ray computed
Magnetic resonance imaging
