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膀胱内卡介苗治疗:对放射科医生腹部影像随访的意义。

Intravesical BCG therapy: implications for radiologists in abdominal imaging follow-up.

作者信息

Naganatanahalli Manisha, Afshari Mirak Sohrab, Ojili Vijayanadh, Ramaiya Nikhil H, Tirumani Sree Harsha

机构信息

Department of Radiology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.

Department of Radiology, University of Texas Health Sciences Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 44106, USA.

出版信息

Abdom Radiol (NY). 2024 Dec 12. doi: 10.1007/s00261-024-04737-3.

Abstract

This study reviews the intravesical Bacillus Calmette-Guérin therapy for treatment of non-muscle invasive bladder cancer including mechanism of action, dosing considerations, treatment success and surveillance. A variety of common and uncommon adverse effects are reviewed with a focus on abdominal -pelvic complications stratified into genitourinary and systemic categories. The complications included more common entities such as chemical cystitis, which has been reported to be present in approximately 35% of the patients to more serious but rare complications such as vascular involvement with only a few reported cases in the literature. For each complication, the pertinent imaging findings and available examples are provided. Additionally, it is important to consider the potential for recurrence or progression of bladder cancer in this patient population, with reported rates of 38.2% and 9.8%, respectively. This underscores the necessity of a thorough differential diagnosis when interpreting imaging findings related to these complications.

摘要

本研究回顾了卡介苗膀胱灌注疗法在治疗非肌层浸润性膀胱癌中的应用,包括作用机制、剂量考量、治疗效果及监测。文中回顾了各种常见和不常见的不良反应,重点关注分为泌尿生殖系统和全身类别的腹盆腔并发症。这些并发症包括更常见的情况,如化学性膀胱炎,据报道约35%的患者会出现,以及更严重但罕见的并发症,如血管受累,文献中仅有少数病例报道。针对每种并发症,提供了相关的影像学表现及实例。此外,考虑到该患者群体中膀胱癌复发或进展的可能性很重要,报道的复发率和进展率分别为38.2%和9.8%。这突出了在解读与这些并发症相关的影像学表现时进行全面鉴别诊断的必要性。

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