Ma Yuan-Hao, Xu Hong-Hao, Xu Wei, Ning Xue-Yi, Liu Hai-Li, Chen Yi-Jian, Cui Meng-Qiu, Bai Xu, Liu Bai-Chuan, Ding Xiao-Hui, Yan Fei, Wang Hai-Yi
Department of Radiology, First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
Department of Pathology, First Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
Jpn J Radiol. 2025 Mar;43(3):483-491. doi: 10.1007/s11604-024-01680-7. Epub 2024 Oct 22.
To explore the diagnostic characteristics of cystitis glandularis (CG) using magnetic resonance imaging (MRI).
A retrospective study was conducted on pathologically confirmed patients who underwent bladder MRI examination between January 2019 and November 2023. Image analysis was jointly conducted, with emphasis on lesion location, morphology, size, signal intensity, and pattern of enhancement, by two genitourinary radiologists with 22 and 15 years of experience, respectively.
A total of 27 patients with 27 lesions were included (median age 47 years, 24 males). The lesions were mostly located in the bladder trigone area (18/27). The lesions could be categorized as focal thickening (17/27), nodular (8/27), and diffuse thickening of the entire bladder (2/27) in morphological terms. On T2-weighted imaging (T2WI), 15 of 17 focal thickening lesions appeared as a slightly hyperintense thickened inner layer, with a higher signal in the center of the thickened inner layer, resembling a sandwich sign, and 6 of 8 nodular lesions were slightly hyperintense. On T1-weighted imaging (T1WI), 19 patients showed slight hypointensity. The lesions on DWI showed mainly high (5/27) and slightly high signal (21/27), with an average mean apparent diffusion coefficient (mADC) value of 2.171 ± 0.052 × 10mm/s. Among the 23 patients who underwent dynamic contrast-enhanced (DCE) scanning, 18 lesions showed mild enhancement in the arterial phase (average 1.7 times comparing to unenhanced phase), and the degree of enhancement gradually increased in the venous and delayed phases (average 2.2 and 2.3 times compared to the unenhanced phase, respectively), showing a progressive enhancement pattern.
On MRI, the majority of CG manifest as focal thickening or nodules in the bladder trigone area, showing slight hyperintensity on T2WI, slight hypointensity on T1WI, and a progressive enhancement pattern, without significant restriction on DWI. Focal thickening lesions may exhibit a special sandwich sign.
探讨腺性膀胱炎（CG）的磁共振成像（MRI）诊断特征。
对2019年1月至2023年11月期间接受膀胱MRI检查且病理确诊的患者进行回顾性研究。由两位分别具有22年和15年经验的泌尿生殖放射科医生共同进行图像分析，重点关注病变的位置、形态、大小、信号强度和强化方式。
共纳入27例患者的27个病变（中位年龄47岁，男性24例）。病变大多位于膀胱三角区（18/27）。从形态学角度，病变可分为局灶性增厚（17/27）、结节状（8/27）和整个膀胱弥漫性增厚（2/27）。在T2加权成像（T2WI）上，17个局灶性增厚病变中的15个表现为内层轻度高信号增厚，增厚内层中央信号更高，类似三明治征，8个结节状病变中的6个为轻度高信号。在T1加权成像（T1WI）上，19例患者表现为轻度低信号。扩散加权成像（DWI）上病变主要表现为高信号（5/27）和轻度高信号（21/27），平均表观扩散系数（mADC）值为2.171±0.052×10⁻³mm²/s。在23例接受动态对比增强（DCE）扫描的患者中，18个病变在动脉期表现为轻度强化（与未增强期相比平均为1.7倍），静脉期和延迟期强化程度逐渐增加（与未增强期相比平均分别为2.2倍和2.3倍），呈渐进性强化模式。
在MRI上，大多数腺性膀胱炎表现为膀胱三角区的局灶性增厚或结节，T2WI上呈轻度高信号，T1WI上呈轻度低信号，强化模式为渐进性，DWI上无明显受限。局灶性增厚病变可能表现出特殊的三明治征。
