协和医学杂志

2014, v.5(02) 166-169

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超声对膀胱副神经节瘤的诊断价值
Role of Ultrasound in the Diagnosis of Paraganglioma of Urinary Bladder

张青;李文波;朱庆莉;姜玉新;齐振红;
ZHANG Qing;LI Wen-bo;ZHU Qing-li;JIANG Yu-xin;QI Zhen-hong;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

摘要(Abstract):

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。
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 catecholamine,and 4( 30. 8%) experienced recurrence within 0. 5 to 3 years. The diameters of 16 lesions( including 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 imaging 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.

关键词(KeyWords): 膀胱肿瘤;副神经节瘤;嗜铬细胞瘤;超声诊断
bladder tumor;paraganglioma;pheochromocytoma;ultrasound diagnosis

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作者(Author): 张青;李文波;朱庆莉;姜玉新;齐振红;
ZHANG Qing;LI Wen-bo;ZHU Qing-li;JIANG Yu-xin;QI Zhen-hong;Department of Ultrasound,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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