增强CT鉴别膀胱炎性肌纤维母细胞瘤与膀胱尿路上皮癌  

Differential diagnosis of inflammatory myofibroblastic tumor of the urinary bladder and bladder urothelial carcinoma by enhanced CT

作　　者：侯宗宾 梁盼[1] 李莉明[1] 高剑波[1] HOU Zongbin;LIANG Pan;LI Liming;GAO Jianbo(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2021年第5期809-812,共4页Journal of Practical Radiology

摘　　要：目的探讨增强CT在鉴别膀胱炎性肌纤维母细胞瘤(IMTUB)和膀胱尿路上皮癌(BUC)中的价值.方法回顾性分析经病理确诊的6例IMTUB患者与22例BUC患者的临床及CT影像资料.采用独立样本t检验(或MannGWhitneyU检验)比较2组间定量资料,采用χ2检验(或Fisher’s确切概率法)比较2组间定性资料.结果IMTUB组和BUC组的性别、年龄、血红蛋白、密度和强化方式的差异均有统计学意义(P<0.05).IMTUB以年轻女性患者多见,BUC以老年男性患者多见,IMTUB患者更有可能出现贫血症状.IMTUB患者CT平扫多表现为囊实性混杂密度肿块,增强后多呈花环状或结节状明显不均匀延迟强化.BUC患者CT平扫多表现为形态规则或不规则均匀密度肿块,增强后多呈轻中度均匀强化.结论IMTUB和BUC的临床表现和CT影像特征相似,性别、年龄、血红蛋白、密度和强化方式有助于鉴别IMTUB和BUC,尤其是CT动态增强扫描呈花环状或结节状明显不均匀延迟强化应考虑IMTUB的可能.Objective To investigate the value of enhanced CT in differential diagnosis of inflammatory myofibroblastic tumor of the urinary bladder(IMTUB)and bladder urothelial carcinoma(BUC).Methods The clinical and CT imaging data of 6 cases with IMTUB and 22 cases with BUC confirmed by pathology were analyzed retrospectively.Independent sample t test(or Mann Whitney U test)was used to compare the quantitative data between the two groups,and Chi-square test(or Fisher1 s exact test)was used to compare the qualitative data between the two groups.Results There were significant differences in sex,age,hemoglobin,density and enhancement pattern between IMTUB group and BUC group(P<0.05).Compared with BUC often found in old male patients,IMTUB was often found in young female patients.IMTUB patients were more likely to have anemia symptoms.In IMTUB group,tumors usually showed as cystic solid mass with mixed density on CT plain images and obvious inhomogeneous delayed enhancement similar to garland or nodosity on enhanced CT images.In BUC group,tumors often showed as regular or irregular homogeneous density mass on CT plain images and mild to moderate homogeneous enhancement on enhanced CT images.Conclusion The clinical manifestation and CT imaging features of IMTUB and BUC are similar.Sex,age,hemoglobin,density and enhancement pattern are helpful to differentiate IMTUB from BUC.When the lesion presents as obvious inhomogeneous delayed enhancement similar to garland or nodosity on enhanced CT images,the possibility of IMTUB should be taken into account.

关 键 词：炎性肌纤维母细胞瘤 膀胱 计算机体层成像 尿路上皮癌 

分 类 号：R737.14[医药卫生—肿瘤] R814.42[医药卫生—临床医学]