Zimmern P E, Laub D, Leach G E
Department of Urology, Kaiser Sunset Medical Center, Los Angeles, California, USA.
J Urol. 1995 Jul;154(1):62-5. doi: 10.1016/s0022-5347(01)67225-2.
Fluorescein angiography has been used in the study of bleeding vessels, neovascularity, tumors and ischemic tissues in a variety of disorders. This pilot study was designed to evaluate the feasibility, safety and relevance of this interesting technology for the evaluation of bladder wall vessels in patients with interstitial cystitis and bladder cancer.
Five patients with National Institutes of Health defined interstitial cystitis symptoms and 10 with bladder cancer were studied during cytoscopy while they were under general anesthesia. A yellow-green barrier filter (520 nm.) was placed over the cystoscope eyepiece and a blue exciter filter (465 nm.) was attached to the light source. Patients received a 5 ml. bolus of 10% fluorescein intravenously.
After hydrodistension, glomerulations in interstitial cystitis patients were more prominent with fluorescein angiography and occurred in the venule phase. Areas of papillary transitional cell tumor and carcinoma in situ developed a brilliant yellow-green fluorescence. Adjacent normal urothelium was nonfluorescent and provided a contrasting dark background facilitating the detection of all lesions. No allergic reaction or other adverse effect related to the fluorescein injection was observed.
These unique observations in a limited number of patients suggest that fluorescein angiography of the bladder is a safe and simple procedure. This preliminary report underscores the relevance of fluorescein angiography in the detection of bladder tumor and offers a new approach to the evaluation of bladder wall vessels in interstitial cystitis patients.
荧光素血管造影已用于多种疾病中出血血管、新生血管、肿瘤及缺血组织的研究。本初步研究旨在评估这项有趣技术用于评价间质性膀胱炎和膀胱癌患者膀胱壁血管的可行性、安全性及相关性。
对5例有美国国立卫生研究院定义的间质性膀胱炎症状的患者及10例膀胱癌患者在全身麻醉下行膀胱镜检查时进行研究。在膀胱镜目镜上放置一个黄绿滤光片（520纳米），并在光源上连接一个蓝色激发滤光片（465纳米）。患者静脉注射5毫升10%的荧光素。
膀胱扩张后，间质性膀胱炎患者的点状出血在荧光素血管造影下更明显，且出现在静脉期。乳头状移行细胞肿瘤及原位癌区域呈现明亮的黄绿荧光。相邻的正常尿路上皮无荧光，形成对比鲜明的暗背景，便于检测所有病变。未观察到与荧光素注射相关的过敏反应或其他不良反应。
在少数患者中的这些独特观察结果表明，膀胱荧光素血管造影是一种安全、简单的检查方法。本初步报告强调了荧光素血管造影在膀胱肿瘤检测中的相关性，并为间质性膀胱炎患者膀胱壁血管的评估提供了一种新方法。
