Department of Radiology, First Medical Center, Chinese PLA General Hospital, Beijing, China.
Department of Radiology, Fifth Medical Center, Chinese PLA General Hospital, Beijing, China.
Radiol Oncol. 2021 Dec 30;56(1):46-53. doi: 10.2478/raon-2021-0055.
Bladder paraganglioma (BPG) is a rare extra-adrenal pheochromocytoma with variable symptoms and easy to be misdiagnosed and mishandled. The aim of the study was to document the imaging features of BPG using computed tomography (CT) and magnetic resonance imaging (MRI).
We retrospectively enrolled consecutive patients with pathology-proven BPG, who underwent CT or MRI examinations before surgery between October 2009 and October 2017. The clinical characteristics, CT, and MRI features of the patients were described and analysed.
A total of 16 patients with 16 bladder tumours (median age 51 years, 9 females) were included. Among them, 13 patients underwent CT examinations and eight patients underwent MRI examinations preoperatively. Tumour diameters ranged from 1.6-5.4 cm. Most of the tumours grew into the bladder cavity (n = 11) with oval shapes (n = 10) and well-defined margins (n = 14). Intratumour cystic degeneration or necrosis (n = 2) was observed. Two lesions showed peripheral tissue invasion, suggesting malignant BPGs. All 13 lesions imaged with CT exhibited slight hypoattenuation and moderate to marked enhancement. Compared to the , all lesions showed slight h yperintensity in T2-weighted images, hyperintensity on diffusion-weighted images (DWI), hypointensity on apparent diffusion coefficient maps, hyperintensity on T1-weighted images and a "fast in and slow out" enhanced pattern on contrast-enhanced MRI images.
BPGs are mostly oval-shaped, broadly-based and hypervascular bladder tumours with hypoattenuation on non-contrast CT, T2 hyperintensity, slight T1 hyperintensity compared to the muscle, marked restricted diffusion on DWI. Peripheral tissue invasion can suggest malignancy of the BPGs. All of these features contribute to preoperative decision-making.
膀胱副神经节瘤（BPG）是一种罕见的肾上腺外嗜铬细胞瘤，其症状多样，容易误诊和处理不当。本研究旨在通过计算机断层扫描（CT）和磁共振成像（MRI）记录 BPG 的影像学特征。
我们回顾性纳入了 2009 年 10 月至 2017 年 10 月期间连续接受病理证实的 BPG 患者，这些患者在术前接受了 CT 或 MRI 检查。描述和分析了患者的临床特征、CT 和 MRI 特征。
共纳入 16 例 16 个膀胱肿瘤患者（中位年龄 51 岁，9 例女性）。其中，13 例患者接受了 CT 检查，8 例患者接受了 MRI 检查。肿瘤直径为 1.6-5.4cm。大多数肿瘤向膀胱腔内生长（n=11），呈椭圆形（n=10），边界清楚（n=14）。观察到肿瘤内囊性变性或坏死（n=2）。2 个病变有周围组织侵犯，提示恶性 BPG。13 例 CT 成像的病变均表现为轻度低衰减，中度至明显强化。与肌肉相比，所有病变在 T2 加权图像上均表现为轻度高信号，在弥散加权图像（DWI）上表现为高信号，在表观弥散系数图上表现为低信号，在 T1 加权图像上表现为高信号，在对比增强 MRI 图像上表现为“快进慢出”强化模式。
BPG 多为椭圆形、基底宽、富血管性膀胱肿瘤，非增强 CT 呈轻度低衰减，T2 呈高信号，与肌肉相比 T1 呈轻度高信号，DWI 呈明显弥散受限。周围组织侵犯提示 BPG 恶性程度较高。所有这些特征有助于术前决策。
