CAJ | 학술논문

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。
목적：탐토초성재방광부신경절류（paraganglioma of urinary bladder， PUB）중적진단개치。방법회고성분석2002년10월지2013년6월북경협화의원경병리증실적13례PUB적림상표현급초성성상도표현。13례환자중남성5례，녀성8례，년령14～76세，평균41.7세。결과9례（69.2％） PUB환자림상표현위배뇨출현두동、심계、출한급혈압증고사련증；12례（92.3％）뇨인다분알증고；4례（30.8％）재0.5～3년내발생복발。13례PUB초성성상도공발현16개병조，병조대소1.2～7.5 cm；병조형태규칙9개（56.3％），불규칙7개（43.8％）；병조변계청석9개（56.3％），기중5개（31.3％）가견련속완정적방광점막，불청석7개（43.8％）；병조회성균위저회성，1개（6.3％）내부가견소양결구。채색다보륵혈류현상시혈류봉부12개（75％），점조상혈류2개（12.5％），미견혈류신호2개（12.5％）。4례（30.8％）출현기타장기수루。결론 PUB초성성상도표현구유일정적특정성，결합기림상특정유조우감별진단，병재판단예후급술후수진중유중요작용。
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.