Department of Radiology, Royal Preston Hospital, Preston, UK.
The University of Manchester, Manchester, UK.
Br J Radiol. 2021 Dec;94(1128):20210660. doi: 10.1259/bjr.20210660. Epub 2021 Oct 6.
Continent diversion with orthotopic neobladder is the most upcoming form of urinary diversion postradical cystectomy. This allows patients to void through the native urethra preserving the maximal quality of life. These patients with greater life expectancies increasingly present with a wide range of late complications, which also include local recurrences involving neobladder. Such presentations on surveillance scans can be challenging for radiologists unfamiliar with expected post-surgical anatomy and usual sites of local recurrences. Tumour in neobladder, although rare, has predilection concerning specific sites of involvement and few distinct histological types. Major subtypes of such recurrences with corresponding radiological features on multimodality imaging have been discussed in this article. Management of such cases with revision of diversions is challenging, and surgeons expect a meticulous read of such scans before contemplating pelvic clearance and secondary diversions. This pictorial review aims to appraise the literature related to various primary and secondary types of tumours involving reservoir and anastomotic sites in an orthotopic neobladder, their relative incidences and illustrate salient imaging points with case examples.
原位新膀胱肠代膀胱术是根治性膀胱切除术后排尿的最先进形式。这允许患者通过原生尿道排尿，从而保持生活质量的最大化。这些预期寿命更长的患者会出现越来越多的各种晚期并发症，其中还包括涉及新膀胱的局部复发。对于不熟悉预期术后解剖结构和常见局部复发部位的放射科医生来说，这些在监测扫描中的表现可能具有挑战性。新膀胱肿瘤虽然罕见，但在特定的受累部位和少数独特的组织学类型上有倾向。本文讨论了此类复发病例的主要亚型及其在多模态成像上的相应放射学特征。这种情况下的处理，包括对转移的修正，具有挑战性，并且外科医生在考虑骨盆清除和二次转移之前，需要对这些扫描进行细致的阅读。本图片回顾旨在评估与储尿囊和吻合部位的各种原发性和继发性肿瘤相关的文献，及其相对发生率，并通过病例举例说明突出的影像学要点。
