膀胱内翻性乳头状瘤的超声诊断  

Ultrasound diagnosis in inverted papilloma of the bladder

作　　者：班永光[1] 马新武[1] 栾钦花[1] 李吉昌[1] 滕剑波[1] 娄丽[1] 宋庆达[1] 刘绍玲[1] 

机构地区：[1]山东省医学影像学研究所,济南250021

出　　处：《中华超声影像学杂志》2013年第7期606-609,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨膀胱内翻性乳头状瘤的彩色多普勒超声表现。方法回顾性分析24例经手术病理证实的膀胱内翻性乳头状瘤患者的临床表现、膀胱镜检查、术中表现及声像图特征。结果24例均行经腹超声检查，发现24个肿块，最大径1．0-3．4cm，其中1-2cm者17例，大于2cm者7例；17例呈乳头状，7例呈菜花状；18例无蒂，6例带蒂，其中2例可见肿块在膀胱腔内摆动；结节呈略强回声（14例）或高回声（10例）。按照内部回声可分为3种类型：Ⅰ型（14例），回声均匀；Ⅱ型（7例），回声不均匀，边缘或内部散在细点状强回声；Ⅲ型（3例），回声不均匀，周边回声强，内部回声低。彩色多普勒血流显像示17例肿块内部未测及明显血流信号，4例测及点状血流信号，3例测及点条状血流信号或条状血流信号。肿块局部膀胱壁均显示连续，肿块后方无衰减。发病部位分别为膀胱三角区（6例）、左后壁（5例）、尿道内口（4例）、右侧壁（3例）、右后壁（3例）、后壁（2例）、左侧壁（1例）。超声误诊为膀胱癌5例，提示实性占位或实性肿瘤者17例，仅有1例考虑乳头状瘤，1例提示良性病变。结论膀胱内翻性乳头状瘤声像图特征为单发，有蒂，呈乳头状或菜花状，表面光滑，最常见发病部位是膀胱颈口处与膀胱三角区。超声检查可作为膀胱内翻性乳头状瘤主要的筛查手段。Objective To explore the ultrasound findings of inverted papilloma of the bladder （IPB）. Methods The clinical manifestation, cystoscopy examination, intraoperative observation and ultrasonographic imaging of 24 patients with IPB, which were confirmed by surgery and pathology examination,were analyzed retrospectively. Results 24 patients underwent ultrasound examination and 24 tumors were found. The maximum diameter of tumors were from 1.0 em to 3.4 cm：l. 0-2.0 cm （ n = 17）, 2.0-3.4 cm （ n = 7）. Tumors were papillary （ n = 17） or cauliflower shape （ n = 7） ,6 cases had pedicles and none in 18 cases,2 cases swung in the bladder cavity. Tumors were slight hyperecho （ n = 14） or high- level echo （n = 10）, and could be divided into three types： homogenous internal echoes （n = 14）, inhomogenous internal echoes with punctiform hyperecho in brim or internal part （ n = 7）,inhomogenous internal echoes with peripheral hyperecho and hypoecho in internal part （n = 3）. Color Doppler flow imaging （CDFI） showed that there were no blood flow signal in 17 cases,punctiform blood flow signal in 4 cases,point and strip blood flow signal or strip blood flow signal in 3 cases. Local bladder walls were continuous and there were no attenuation behind the tumors. The onset position were：triangular area （ n = 6） ,left posterior wall （ n = 5） ,internal urethral orifice （ n = 4）, right lateral wall （ n = 3）, right posterior wall （n = 3）, posterior wall （n = 2）, left lateral wall （n = 1）. 5 cases were misdiagnosed as bladder carcinoma,and 17 cases were considered as solid tumors,and only 1 case was diagnosed as papilloma,and 1 case was considered as benign lesion. Conclusions The representative ultrasonographic imaging of IPB are mostly single,pedunculated, papillary or cauliflower shape with smooth surface,neck and trigone of bladder are the most risk position. Color Doppler ultrasonography can be used as the important screening process for IPB.

关 键 词：超声检查 膀胱肿瘤 乳头状瘤 内翻 

分 类 号：R737.14[医药卫生—肿瘤]