Dershaw D D, Scher H I
Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
AJR Am J Roentgenol. 1988 May;150(5):1055-9. doi: 10.2214/ajr.150.5.1055.
In 23 patients with known transitional cell carcinoma of the bladder, 58 serial transabdominal sonograms were obtained, providing 35 cases in which interval change could be evaluated by sonography. Results were correlated with cystoscopy or surgery. Sonography accurately gauged change in 29 instances (83%), of which 13 showed increase, four decrease, and 12 stability of tumor. Errors in assessing interval change occurred when surgery between sonograms caused secondary bladder deformity or patchy edema of the bladder wall; these were misinterpreted as tumor growth. When smooth bladder thickening was present, sonography could not differentiate flat tumor from edema. In no case in which the bladder wall was normal on sonography was tumor found. In four cases sonography was a more accurate indicator of depth of tumor than cystoscopy was. These results suggest that sonography is a useful adjunct to cystoscopy and may be a dependable means of decreasing the frequency of invasive procedures to evaluate the extent of bladder disease. The use of these two techniques together may improve the accuracy achieved by using cystoscopy alone.
对23例已知膀胱移行细胞癌患者进行了58次系列经腹超声检查，其中35例可通过超声评估间期变化。结果与膀胱镜检查或手术结果进行了对比。超声在29例（83%）中准确判断了变化情况，其中13例显示肿瘤增大，4例减小，12例肿瘤稳定。在超声检查间期进行的手术导致膀胱继发畸形或膀胱壁片状水肿时，评估间期变化会出现错误，这些情况被误判为肿瘤生长。当膀胱壁出现光滑增厚时，超声无法区分扁平肿瘤与水肿。超声检查显示膀胱壁正常的病例中均未发现肿瘤。有4例超声在判断肿瘤深度方面比膀胱镜更准确。这些结果表明，超声是膀胱镜检查的有用辅助手段，可能是减少评估膀胱疾病范围的侵入性检查频率的可靠方法。联合使用这两种技术可能会提高单独使用膀胱镜检查的准确性。
