氯胺酮相关性膀胱炎的影像学表现

发布时间：2018-05-28 02:18

本文选题：氯胺酮相关性膀胱炎 + 体层摄影术　；参考：《临床放射学杂志》2017年03期

【摘要】：目的总结氯胺酮相关性膀胱炎(KIC)的CT、膀胱造影及IVP表现。方法回顾性分析41例长期吸食氯胺酮且出现严重膀胱刺激征患者的CT、膀胱造影及IVP资料,探讨KIC的影像学特点。结果25例行CT检查,均见膀胱挛缩,呈"葫芦征"、"鸟嘴征"改变,壁不规则增厚,双侧壁及(或)前壁增厚16例(64.0%),膀胱全壁增厚5例(20.0%),膀胱壁结节状增厚2例(8.0%),右侧壁及后壁各1例(4.0%),平均增厚约10.4 mm(10.4±4.8,4~25 mm),平扫密度平均为39.4 HU(39.4±3.4,35~46 HU),增强扫描密度平均为54.4 HU(54.4±4.9,50~66 HU),并见明显强化不规则增厚的膀胱黏膜线。发现不同程度上尿路扩张11例(44.0%),其中的10例输尿管下段管壁增厚,另外1例双侧输尿管全程增厚及双肾实质损伤。3例(12.0%)合并膀胱结石。32例行膀胱造影,29例(90.6%)膀胱边缘不光滑,严重者囊袋状向外突出,多数容量明显减小,小于100 ml 26例(81.3%),6例大于100 ml,发现输尿管反流10例(31.3%)。15例行IVP检查,膀胱壁边缘不光滑,7例(46.7%)输尿管扩张,2例(13.3%)输尿管出口狭窄。结论KIC具有一定的影像学特征,CT、膀胱造影、IVP三者结合有助于提高对KIC的全面观察,提高诊断准确率。
[Abstract]:Objective to summarize the CT, cystography and IVP findings of ketamine associated cystitis. Methods the CT, cystography and IVP data of 41 patients with chronic ketamine smoking and severe bladder irritation were analyzed retrospectively, and the imaging features of KIC were discussed. Results in 25 cases, bladder contracture was found in all cases, showing "gourd sign", "bird mouth sign" and irregular thickening of wall. Bilateral wall and / or anterior wall thickened in 16 cases, bladder wall thickened in 5 cases, bladder wall nodule thickened in 2 cases, right wall and posterior wall in 1 case, the average thickening was about 10.4 mm(10.4 卤4.8n 425mm, the average plain scan density was 39.4 HU(39.4 卤3.4 卤3.35 卤46 HUT. The results were 54.4 HU(54.4 卤4.9 HU(54.4, and obviously enhanced irregularly thickened bladder mucosal lines. It was found that there were 11 cases of urinary tract dilatation in varying degrees, including 10 cases with thickening of the lower ureter wall, 1 case with bilateral ureteral thickening and 3 cases with bilateral renal parenchyma injury (12.0) with bladder calculi. 32 cases with cystography and 29 cases with urography. In severe cases, most of the sacs protruded outward, and most of the volume decreased significantly. 26 cases with ureteral reflux less than 100ml (81.3 ml) were found to have ureteral reflux in 6 cases (> 100ml). Ureteral reflux was found in 10 cases (31. 3%). 15 cases were examined with IVP, 7 cases with non smooth bladder wall and 7 cases with dilatation of ureter, 2 cases with ureteral dilatation and 2 cases with ureteral outlet stenosis. Conclusion KIC has some imaging features. The combination of cystography and IVP can improve the overall observation of KIC and improve the diagnostic accuracy.
【作者单位】：南方医科大学珠江医院放射科;
【分类号】：R694.3;R816.7

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