膀胱副神经节瘤五例的临床和影像学特征报告并文献复习

目的总结分析膀胱副神经节瘤的临床和影像学特征。 方法回顾性分析我院2012年12月至2020年7月经手术病理证实的5例膀胱副神经节瘤的患者资料，分析其临床和影像学特征，并进行文献复习。 结果5例患者临床仅1例表现为无明显诱因尿频、尿急、尿痛，余4例均为体检偶然发现。CT、MRI均显示膀胱占位性病变，1例位于肌壁间，椭圆形，表面光滑，4例位于膀胱黏膜下，形态不规则，表面凹凸不平。CT平扫密度偏高、均匀，未见囊变、坏死、钙化，MRI T1WI及T2WI均显示等稍高信号，增强扫描瘤灶明显强化，黏膜下病灶均与邻近膀胱壁分界不清，局部膀胱壁增厚、强化。 结论膀胱副神经节瘤是一种少见的膀胱良性肿瘤，无症状的膀胱副神经节瘤术前常误诊为膀胱癌。正确认识其影像学表现，结合典型临床表现，术前可提示该病的诊断，有助于泌尿外科医师手术方式的选择，避免术中并发症的发生。

Clinical manifestations and imaging features of paraganglioma of urinary bladder of 5 cases and literature review

ObjectiveTo investigate the clinical manifestations and imaging features of paraganglioma of the urinary bladder (PUB). MethodsThe clinical manifestations, pathological and imaging features of five patients with pathologically proved PUB were analyzed retrospectively between Dec. 2012 to Jul. 2020 in our hospital, and related literatures were reviewed. ResultsOnly 1 patient of the five presented with dysuria, urinary frequency and urgency, the other 4 cases were found by chance in physical examination. All the 5 lesions presented as solid mass on CT or MRI imaging features,1 was intramural, oval shape with smooth surface, 4 were submucosal, irregular shape with uneven surface. All lesions had homogeneous density without cystic, necrosis or calcification. MRI showed slightly higher signal intensity on both T1WI and T2WI, focal enhancement was obvious. Submucosal lesions were indistinct with the adjacent bladder wall, and local bladder wall was thickened and enhanced. ConclusionsPUB is a rare type of benign lesions, those asymptomatic PUB were often misdiagnosed as malignant neoplasm pre-operatively. Familiarity with the imaging features, combined with typical clinical manifestations, bladder paraganglioma should be considered as a differential diagnosis to neoplasm before operation, which is helpful for the urologists to make correct surgical methods and avoid complications during operation.