国人气肿性膀胱炎的CT影像表现荟萃分析  

MSCT Diagnosis and Differential Diagnosis of Abdominal Cocoon(with Report of 14 Cases)

作　　者：杨先春[1] 陈莉[1] 吴汉斌[1] 左敏[1] YANG Xian-chun;CHEN Li;WU Han-bin(Department of Radiology,The Affiliated Hanyang Hospital of the Science and Technology University,Wuhan 430050,Hubei Province,China)

机构地区：[1]武汉科技大学附属汉阳医院放射科,湖北武汉430050

出　　处：《中国CT和MRI杂志》2019年第5期119-122,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨气肿性膀胱炎的CT影像特征,提高对该病的认识和诊断水平。方法以"气肿性膀胱炎"作为关键词在1997年至2017年间中国期刊全文数据库中检索相关文献病例报道,并提取相关病例的临床资料及CT影像资料进行荟萃分析,并对气肿性膀胱炎主要CT征象进行ROC曲线分析。结果共计检索出24篇个案文献36例经临床诊断为气肿性膀胱炎,有4例因诊断标准不符合列为疑似诊断;男8例,女28例,有糖尿病22例,糖尿病外其它基础病11例,无基础疾病3例。血尿18例,尿路刺激症5例,气尿5例;血WBC升高11例,尿WBC升高18例,尿细菌实验(+)28例,其中大肠埃希菌14例,肺炎克雷伯杆菌6例,其它细菌7例,真菌1例。CT主要表现:膀胱壁"气抱球征"29例,膀胱腔内气液平面27例,膀胱肿大16例,膀胱壁毛糙20例,膀胱壁增厚14例,气腹2例,膀胱周围间隙浑浊模糊4例,肾盂输尿管积水7例。膀胱壁"气抱球征"诊断敏感性90.6%,特异性100%,ROC曲线下面积0.953;膀胱腔内气液平面敏感性87.1%,特异性50%,ROC曲线下面积0.694;两者ROC曲线下面积比较没有统计学意义。结论气肿性膀胱炎的CT表现具有一定的特征性,"气抱球征"是气肿性膀胱炎最具特异性的MSCT征象。典型CT表现结合临床相关病史及实验室检查有助于气肿性膀胱炎临床早期诊断和及时治疗。Objective To investigate the CT features of emphysematous cystitis,in order to improve its diagnostic accuracy.Methods Literature searching was done in china national knowledge infrastructure database from 1997 to 2017 using"emphysematous cystitis",and the clinical datas and CT imaging datas of related cases were extracted and analyzed.Results A total of 36 cases of emphysematous cystitis diagnosed by clinical and CT imaging were retrieve in 24 literature.There were 8 males and 28 females,including 22 cases of diabetes,11 cases of other basic diseases outside diabetes,and 3 cases without underlying diseases.There were 18 cases of hematuria,5 cases of irritation of urinary tract,5 cases of gas and urine,11 cases of elevated blood WBC,18 cases of elevated WBC and 28 cases of urine bacteria test(+),of which 14 cases were Escherichia coli,6 cases were Klebsiella pneumoniae,7 cases were other bacteria,and 1 cases were fungi.CT findings included:the bladder wall"gas holding ball"sign(29 cases),bladder enlargement(16 cases),bladder wall thickening(14 cases),bladder wall rough(20 cases),air-fluid level within bladder(27 cases),pneumoperitoneum(2cases),bladder gap around the opaque(4 cases),ureterohydronephrosis(7 cases).The sensitivity and specificity for the"gas holding ball"sign of the bladder wall was 90.6%,100%,the area under the ROC curve was 0.953.The sensitivity and specificity for bladder liquid surface was 87.1%,50%,the area under the ROC curve was 0.694.There wasn't statistically differences between they areas of ROC curve.Conclusion The CT manifestations of emphysematous cystitis are characteristic,and the"gas holding ball"sign of the bladder wall is the most specific MSCT sign of emphysematous cystitis.The typical CT manifestations of emphysematous cystitis combined with clinical history and laboratory examination are helpful to the early diagnosis and timely treatment of the disease.

关 键 词：气肿性膀胱炎 体层摄影 X线计算机 

分 类 号：R694.3[医药卫生—泌尿科学] R445.3[医药卫生—外科学]