Koelbl H, Bernaschek G
Second Department of Obstetrics and Gynecology, University of Vienna, Austria.
Obstet Gynecol. 1988 Dec;72(6):951-4.
Thirty-five patients with advanced gynecologic malignancies (cervical cancer, N = 26; endometrial cancer, N = 5; ovarian cancer, N = 2; vaginal cancer, N = 2) underwent cystoscopy and subsequent cystosonography. The mean age was 61.6 years (range 33-78). The bladder wall was found intact in three patients regardless of the diagnostic procedure. A mere displacement of the bladder wall was observed in four cases using cystoscopy. In all of these women, tumor invasion was ascertained by cystosonography alone. Edema of the bladder mucosa was found in 14 women by cystoscopy and in six women by cystosonography. Endosonography detected tumor invasion of the external layers of the bladder in eight of 14 women. In six of 14 patients, edema was caused by bladder displacement without neoplastic infiltration. Tumor invasion of the bladder was ascertained in six women by cystoscopy and intravesical sonography. Both cystoscopy and intravesical sonography demonstrated neoplastic infiltration and edema of the bladder mucosa in eight patients. Compared with cystoscopy, cystosonographic demonstration of the perivesical region provided better evaluation of the extent of bladder invasion. Cystosonography is a diagnostic adjunct to mere cystoscopy for patients with gynecologic malignancies. This modality is an excellent diagnostic tool, especially if cystoscopy reveals pathologic findings such as edema and displacement or invasion of the bladder wall.
35例晚期妇科恶性肿瘤患者（宫颈癌26例、子宫内膜癌5例、卵巢癌2例、阴道癌2例）接受了膀胱镜检查及随后的膀胱超声检查。平均年龄为61.6岁（范围33 - 78岁）。3例患者无论诊断方法如何，膀胱壁均完整。4例患者通过膀胱镜检查仅观察到膀胱壁移位。在所有这些女性中，仅通过膀胱超声检查确定肿瘤侵犯。膀胱镜检查发现14例女性存在膀胱黏膜水肿，膀胱超声检查发现6例女性存在膀胱黏膜水肿。超声内镜检查在14例女性中的8例检测到膀胱外层肿瘤侵犯。14例患者中的6例，水肿是由膀胱移位而非肿瘤浸润引起。通过膀胱镜检查和膀胱内超声检查确定6例女性存在膀胱肿瘤侵犯。膀胱镜检查和膀胱内超声检查均显示8例患者存在膀胱黏膜肿瘤浸润和水肿。与膀胱镜检查相比，膀胱超声检查对膀胱周围区域的显示能更好地评估膀胱侵犯程度。对于妇科恶性肿瘤患者，膀胱超声检查是单纯膀胱镜检查的辅助诊断方法。这种检查方式是一种优秀的诊断工具，尤其是当膀胱镜检查发现诸如水肿、移位或膀胱壁侵犯等病理表现时。
