CT与MR诊断膀胱憩室癌的临床案例分析

高明子; 闫城; 张靓雯; 韩婧; 张明鑫; 赵丽琴

doi:10.15953/j.ctta.2023.227

CT与MR诊断膀胱憩室癌的临床案例分析

首都医科大学附属北京天坛医院放射科, 北京100070

基金项目: 天坛医院引进人才启动基金（ZLQ-2020RCYJ）。

详细信息

作者简介:
高明子: 女，首都医科大学放射影像学专业研究生，E-mail：gmz19991224@163.com

通讯作者:
赵丽琴: 女，博士，首都医科大学附属北京天坛医院放射科主任医师、教授，首都医科大学博士研究生导师，主要研究方向为腹部影像诊断，E-mail：zhaolq0129@163.com。

中图分类号: R 814；R 445
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出版历程
- 收稿日期: 2023-12-21
- 修回日期: 2024-02-24
- 录用日期: 2024-02-26
- 网络出版日期: 2024-03-27
- 刊出日期: 2024-09-04

CT and MR Diagnosis of Bladder Diverticulum Carcinoma: Analysis of a Clinical Case

Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

摘要

摘要:
膀胱憩室癌是生长在膀胱憩室的恶性肿瘤，发病率低，常见于老年男性，临床症状以无痛性肉眼血尿为主要表现。膀胱憩室癌多发生于获得性膀胱憩室中，相对于其他膀胱腔内肿瘤更易向周围浸润。本文报告1例膀胱憩室癌，临床表现为左下腹肿物伴肉眼血尿，CT及MR检查示盆腔左侧占位，局部与膀胱壁相连，考虑来源于膀胱，手术及病理证实为膀胱憩室癌。CT及MR增强检查可以作为膀胱憩室癌推荐的无创性影像学检查，有助于明确膀胱憩室癌的部位及肿瘤分期情况，CT尿路造影对该的鉴别诊断有重要价值。本文旨在总结膀胱憩室癌的临床表现、影像学特征、鉴别诊断及治疗方法，以提高对该病的认知，从而有助于通过影像检查手段对该病做出准确诊断。
- 影像学特征 /
- 膀胱 /
- 憩室癌 /
- 鉴别诊断
Abstract:
Bladder diverticulum cancer is a malignant tumor growing in the bladder diverticulum. Its incidence rate is low, and it is common in elderly men. The main clinical symptom is painless gross hematuria. Bladder diverticulum cancer often occurs in acquired bladder diverticula and is more prone to infiltrating the surrounding area than other bladder tumors. In this article, we report a case of bladder diverticulum cancer clinically manifested as a mass in the lower left abdomen with gross hematuria. CT and MR examinations showed a mass on the left side of the pelvic cavity, locally connected to the bladder wall, and suspected to originate from the bladder. Surgery and pathology confirmed the diagnosis as bladder diverticulum cancer. Enhanced CT and MR are the recommended non-invasive imaging examinations for bladder diverticulum cancer that help clarify its location and tumor staging. CT urography has a great value in differential diagnosis. In this article, we aimed to summarize the clinical manifestations, imaging features, differential diagnosis, and treatment methods of bladder diverticulum cancer to improve our understanding of the disease and help make accurate diagnosis through imaging examination.
- imaging features /
- bladder /
- diverticular carcinoma /
- differential diagnosis

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图 1 盆腔平扫及增强CT

Figure 1. Pelvic unenhanced CT and enhanced CT images

下载: 全尺寸图片幻灯片

图 2 盆腔MR扫描

注：（a）T1WI 盆腔左侧不规则肿块，以等信号为主，局部与膀胱壁相连（b）脂肪抑制 T2WI 显示病灶内缘呈等、稍低信号，边缘呈稍高信号（c）DWI 及（d）ADC 图显示病灶中心弥散明显受限，外周弥散未见明显受限；动脉期（e）、静脉期（f）、延迟期（g）增强显示病变外侧于动脉期不均匀强化，内侧轻度强化；静脉期及平衡期轻度延迟强化。

Figure 2. Pelvic unenhanced MR and three-phase enhanced MR images.

下载: 全尺寸图片幻灯片

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