超声对膀胱副神经节瘤的诊断价值

  目的  探讨超声在膀胱副神经节瘤(paraganglioma of urinary bladder, PUB)中的诊断价值。  方法  回顾性分析2002年10月至2013年6月北京协和医院经病理证实的13例PUB的临床表现及超声声像图表现。13例患者中男性5例, 女性8例, 年龄14~76岁, 平均41.7岁。  结果  9例(69.2%)PUB患者临床表现为排尿出现头疼、心悸、出汗及血压增高四联症; 12例(92.3%)尿儿茶酚胺增高; 4例(30.8%)在0.5~3年内发生复发。13例PUB超声声像图共发现16个病灶, 病灶大小1.2~7.5 cm; 病灶形态规则9个(56.3%), 不规则7个(43.8%); 病灶边界清晰9个(56.3%), 其中5个(31.3%)可见连续完整的膀胱黏膜, 不清晰7个(43.8%); 病灶回声均为低回声, 1个(6.3%)内部可见巢样结构。彩色多普勒血流显像示血流丰富12个(75%), 点条状血流2个(12.5%), 未见血流信号2个(12.5%)。4例(30.8%)出现其他脏器受累。  结论  PUB超声声像图表现具有一定的特征性, 结合其临床特征有助于鉴别诊断, 并在判断预后及术后随诊中有重要作用。

Role of Ultrasound in the Diagnosis of Paraganglioma of Urinary Bladder

Objective To explore the role of ultrasound in diagnosis of paraganglioma of urinary bladder （PUB）.Methods The clinical data and urinary bladder sonographic findings of 13 patients （8 females and 5 males, aged 14-76 years） with pathologically confirmed PUB in Peking Union Medical College Hospital from October 2002 to June 2013 were retrospectively analyzed .Results Among these 13 patients, 9 （69.2%） had headache, palpitation, sweating, and hypertension with micturition, 12 （92.3%） had elevated urinary cate-cholamine, and 4 （30.8%） experienced recurrence within 0.5 to 3 years.The diameters of 16 lesions （inclu-ding 10 solitary lesions and 3 multiple lesions ） found in these 13 patients were 1.2-7.5 cm.Nine lesions were morphologically regular and 7 （43.8%） were irregular.The margins were well-defined in 9 lesions （56.3%）, with continuous bladder mucosa found in 5 lesions （31.3%）, and were poorly-defined in 7 lesions （43.8%）. All the lesions were hypoechoic , and nest-like structure was seen inside one lesion （6.3%） .Color Doppler ima-ging showed rich blood flow signals in 12 lesions （ 75%） , spot-and strip-like blood flow signals in 2 lesions （ 12.5%） , and no blood flow signal in 2 lesions （12.5%） .Involvement of other organs was reported in 4 cases （30.8%）.Conclusions The sonographic findings of PUB are somehow unique .When combined with clinical features, it is helpful in the differentiation diagnosis , prediction of treatment outcome , and follow-up.