膀胱原发性非脐尿管腺癌的临床及MRI特征  

Clinical and MRI features of primary non-urachal adenocarcinoma of the bladder

作　　者：陈颖[1] 鲍宽主 刘佳伟 郝金钢[1] CHEN Ying;BAO Kuanzhu;LIU Jiawei;HAO Jingang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《实用放射学杂志》2024年第8期1308-1311,共4页Journal of Practical Radiology

基　　金：云南省医学学科带头人培养项目(D-2018012);昆明医科大学研究生创新基金项目(2023S306)。

摘　　要：目的探讨膀胱原发性非脐尿管腺癌的临床及MRI特点。方法回顾性分析经病理证实为膀胱原发性非脐尿管腺癌9例患者的临床及MRI资料。结果所有患者中临床症状出现血尿7例,尿路刺激征5例。MRI表现为膀胱壁弥漫性增厚1例,膀胱内单发结节/菜花状肿块8例,T1WI呈等至稍低信号,T2WI呈稍高信号,部分患者可见片状T2WI高信号区。表观扩散系数(ADC)0.83~1.85×10^(-3)mm^(2)/s,平均约1.23×10^(-3)mm^(2)/s,强化程度为轻至明显强化,部分呈边缘或分隔样强化,可见片状或弥漫分布的无强化区。所有患者均未见囊变及坏死,侵犯肌层及肌层以上7例,3例淋巴结转移,2例远处转移。结论膀胱原发性非脐尿管腺癌的临床及MRI表现具有一定特征:患者多见血尿及尿路刺激征,部分可有黏液尿;MRI可见病灶单发、侵袭性强、T2WI信号较高、囊变及坏死少见。这些特征在一定程度上有助于提高术前诊断准确率,确诊仍依赖病理。Objective To investigate the clinical and MRI features of primary non-urachal adenocarcinoma of the bladder.Methods The clinical and MRI data of 9 patients with histopathologically confirmed primary non-urachal adenocarcinoma of the bladder were analyzed retrospectively.Results Clinical symptoms of hematuria were present in 7 cases and urinary irritation symptoms in 5 cases among all patients.On MRI,1 case showed diffuse thickening of the bladder wall,8 cases showed a solitary nodular/cauliflower-like mass in the bladder with iso-hypointensity on T1WI and slight hyperintensity on T2WI,and patchy areas of hyperintensity on T2WI were seen in some patients.The apparent diffusion coefficient(ADC)ranging from 0.83×10^(-3)mm^(2)/s to 1.85×10^(-3)mm^(2)/s,mean ADC was approximately 1.23×10^(-3)mm^(2)/s.Dynamic enhancement showed mild to marked enhancement,with some rim or compartmentalized enhancement,and patchy or diffusely distributed areas of no enhancement can be seen.No cystic changes and necrosis were seen in all patients,invasion of the muscularis propria and above were seen in 7 cases,lymph node metastasis was seen in 3 cases,and distant metastasis was seen in 2 cases.Conclusion Primary non-urachal adenocarcinoma of the bladder has certain clinical and MRI features.Patients often present with hematuria and urinary irritation symptoms,and some may present with blennuria.MRI shows that the lesion is solitary and more aggressive,with some hyperintensity on T2WI,cystic changes and necrosis are rare.These features help to improve the accuracy of preoperative diagnosis to some extent,and the final diagnosis still relies on pathology.

关 键 词：膀胱 原发性非脐尿管腺癌 磁共振成像 

分 类 号：R737.14[医药卫生—肿瘤] R445.2[医药卫生—临床医学]