2.Retrograde Transurethral Contrast-enhanced Ultrasound in the Diagnosis of Bladder Rupture:Report of Two Cases.
Chao ZHANG ; Ying-Ying LI ; Ming-Bo ZHANG
Acta Academiae Medicinae Sinicae 2022;44(5):929-932
		                        		
		                        			
		                        			Bladder rupture refers to a series of diseases caused by bladder wall laceration and urine flowing into the abdominal cavity.Two cases of bladder rupture diagnosed by retrograde transurethral contrast-enhanced ultrasound were reviewed in this report.We discussed the value of retrograde transurethral contrast-enhanced ultrasound in the diagnosis,classification,and prognosis evaluation of bladder rupture,aiming to provide evidence for clinical diagnosis and treatment.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Urinary Bladder/diagnostic imaging*
		                        			;
		                        		
		                        			Ultrasonography
		                        			;
		                        		
		                        			Prognosis
		                        			
		                        		
		                        	
3.Clinicopathological Analysis of Brain Metastatic Carcinoma in Tibet.
Zhen DA ; Zhen HUO ; Han-Huan LUO ; Rui-Qian LIAO ; Qian WANG
Acta Academiae Medicinae Sinicae 2021;43(6):869-874
		                        		
		                        			
		                        			Objective To investigate the clinicopathological features and immunohistochemical phenotypes of brain metastatic carcinoma in Tibetan patients. Methods The clinical and pathological data of all patients with brain metastases from 2014 to 2020 in Tibet Autonomous Region People's Hospital were retrospectively analyzed,including 13 cases of brain metastatic carcinoma.All cases were diagnosed and classified by immunohistochemical staining. Results 13 cases(9 males and 4 females)of brain metastatic carcinoma,aged 26-62 years old,present with headache,dizziness,nausea and vomiting clinically.Four patients had a medical history of tumor,and among the 9 patients with no history of tumor,7 present space occupying lesions in both the brain and other organs.Imaging data could be found in 10 cases,including 4 cases of single lesion and 6 cases of multiple lesions.Primary tumors were identified in 11 cases(8 located in the lung,including 4 cases of adenocarcinoma,3 cases of small cell carcinoma,and 1 case of squamous cell carcinoma;1 case of urothelial carcinoma of the renal pelvis;1 case of thyroid papillary carcinoma;1 case of uterine choriocarcinoma),whereas the primary tumor was unknown for the other 2 cases(1 case of small cell carcinoma and 1 case of adenocarcinoma). Conclusions Brain metastatic carcinoma are more common among middle-aged and elderly people in Tibet.Most of the cases have no history of tumor,with the initial site at the brain metastatic lesions.The most common primary site is the lung,and the primary site of some cases is unknown.Multiple lesions are common in brain metastatic carcinoma,especially in the cerebral hemisphere.For older patients with multiple brain space occupying lesions,the possibility of brain metastatic carcinoma increases.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Brain
		                        			;
		                        		
		                        			Brain Neoplasms/diagnostic imaging*
		                        			;
		                        		
		                        			Carcinoma, Transitional Cell
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Thyroid Neoplasms
		                        			;
		                        		
		                        			Tibet
		                        			;
		                        		
		                        			Urinary Bladder Neoplasms
		                        			
		                        		
		                        	
4.Clinical features of neurogenic bladder with vesicoureteral reflux in children.
Meng SHEN ; Xin-Yue PAN ; Jie-Qiu ZHUANG ; De-Xuan WANG ; Hui CAI
Chinese Journal of Contemporary Pediatrics 2021;23(3):279-282
		                        		
		                        			OBJECTIVE:
		                        			To study the clinical features of vesicoureteral reflux (VUR) in children with neurogenic bladder (NB), and to provide a reference for its early diagnosis and treatment.
		                        		
		                        			METHODS:
		                        			Clinical data were collected from 26 children with NB and urinary tract infection who were admitted to the Department of Pediatric Nephrology from January 2014 to December 2019. According to the presence or absence of VUR, the children were divided into a VUR group with 11 children and a non-VUR group with 15 children. Clinical features were compared between the two groups.
		                        		
		                        			RESULTS:
		                        			Compared with the non-VUR group, the VUR group had a significantly higher proportion of children with non-
		                        		
		                        			CONCLUSIONS
		                        			When NB children have the clinical manifestations of non-
		                        		
		                        		
		                        		
		                        			Child
		                        			;
		                        		
		                        			Creatinine
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Radionuclide Imaging
		                        			;
		                        		
		                        			Urinary Bladder, Neurogenic/etiology*
		                        			;
		                        		
		                        			Urinary Tract Infections/etiology*
		                        			;
		                        		
		                        			Vesico-Ureteral Reflux/diagnostic imaging*
		                        			
		                        		
		                        	
5.Three-dimensional modeling of female urinary system based on MRI and CT data.
Lan CHEN ; Chunlin CHEN ; Ping LIU ; Ruiying CHEN ; Caixia LI ; Lian TANG ; Kedan LIAO ; Wenxuan JIANG ; Shiqi LIANG
Journal of Zhejiang University. Medical sciences 2020;40(7):1056-1061
		                        		
		                        			OBJECTIVE:
		                        			To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data.
		                        		
		                        			METHODS:
		                        			MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model.
		                        		
		                        			RESULTS:
		                        			The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm).
		                        		
		                        			CONCLUSIONS
		                        			Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Imaging, Three-Dimensional
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Models, Anatomic
		                        			;
		                        		
		                        			Muscle, Skeletal
		                        			;
		                        		
		                        			Tomography, X-Ray Computed
		                        			;
		                        		
		                        			Urethra
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			Urinary Bladder
		                        			;
		                        		
		                        			diagnostic imaging
		                        			
		                        		
		                        	
6.Is computed tomography cystography indicated in children with pelvic fractures?
Alexander BECKER ; Ori YASLOWITZ ; Joseph DUBOSE ; Kobi PELEG ; Yaakov DASKAL ; Adi GIVON ; Boris KESSEL
Chinese Journal of Traumatology 2020;23(3):181-184
		                        		
		                        			PURPOSE:
		                        			Pelvic fracture evaluation with abdominopelvic computed tomography (CT) and formal CT cystography for rule out of urine bladder injury have been commonly employed in pediatric trauma patients. The additional delayed imaging required to obtain optimal CT cystography is, however, associated with increased doses of ionizing radiation to pelvic organs and represent a significant risk in the pediatric population for future carcinogenic risk. We hypothesized that avoidance of routine CT cystography among pediatric pelvic fracture victims would not result in an appreciable rate of missed bladder injuries and would aid in mitigating the radiation exposure risk associated with these additional images.
		                        		
		                        			METHODS:
		                        			A retrospective cohort study involving blunt trauma pelvic fractures among pediatric trauma patients (age<14) between the years 1997 and 2016 was conducted utilizing the Israeli National Trauma Registry. Statistical analysis was performed using SAS statistical software version 9.4 via the tests of Chi-square test and two-sided Fisher's exact test. A p value of less than 0.05 was considered statistically significant.
		                        		
		                        			RESULTS:
		                        			A total of 1072 children were identified from the registry for inclusion. Mean age of patients was 7.7 years (range 0-14) and 713 (66.5%) were male. Overall mortality in this population was 4.1% (44/1072). Only 2.1% (23) of pediatric patients with pelvic fractures had bladder injury identified, with just 9 children having intraperitoneal bladder rupture (0.8% of all the patients).
		                        		
		                        			CONCLUSION
		                        			The vast majority of blunt pediatric trauma victims with pelvic fractures do not have urine bladder injuries. Based on our study results we do not recommend the routine utilization of CT cystography in this unique population.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Cystography
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Fractures, Bone
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Pelvic Bones
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			injuries
		                        			;
		                        		
		                        			Risk
		                        			;
		                        		
		                        			Tomography, X-Ray Computed
		                        			;
		                        		
		                        			methods
		                        			;
		                        		
		                        			Unnecessary Procedures
		                        			;
		                        		
		                        			Urinary Bladder
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			injuries
		                        			
		                        		
		                        	
7.Bladder cancer local staging about muscle invasion: 3.0T MRI performance following transurethral resection.
Shi Ming ZHAO ; Tie Jun YANG ; Chun Miao XU ; Xiao Feng GUO ; Yong Kang MA ; Xue Jun CHEN ; Xiang LI ; Chao Hong HE
Journal of Peking University(Health Sciences) 2020;52(4):701-704
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the performance of 3.0T magnetic resonance imaging examination (MRI) for the local detecting of muscle invasive bladder cancer following transurethral resection of bladder tumor (TURBT).
		                        		
		                        			METHODS:
		                        			Retrospective study identified 55 patients with pathology-proven bladder cancer who underwent transurethral resection of bladder tumor followed by 3.0T magnetic resonance imaging between September 2012 and April 2019 in our hospital. Two radiologists reviewed pelvic magnetic resonance imaging together and judged muscle invasive bladder cancer. Sensitivity, specificity and accuracy were calculated for the presence of muscle invasion by T2 weighted imaging (T2WI) only, diffusion-weighted imaging (DWI) only and T2WI+DWI compared with the findings at radical cystectomy as the reference standard.
		                        		
		                        			RESULTS:
		                        			Of the 55 patients with pathological results from radical cystectomy, 3.64% (2/55) had no residual disease; 29.09% (16/55) were non-muscle invasive bladder cancer on pathology, including 13 cases in T1 and 3 cases in Ta; 34.55% (19/55) were in stage T2 depending on pathology, 25.45% (14/55) in T3, and 7.27% (4/55) in T4. The average age was 60.76 years, ranging from 42 to 82 years. There were 48 males and 7 females in our study. Before pelvic MRI examination, all the patients received transurethral resection of bladder tumor, including 16 cases taking the operation in our hospital and 39 cases in other hospitals. The interval between the pelvic MRI examination and transurethral resection of bladder tumor was more than 2 weeks in all the patients. They all underwent radical cystectomy within 1 month after the pelvic MRI examination, and no patient underwent radiotherapy or chemotherapy in our study during the interval between the MRI examination and radical cystectomy. T2WI only, DWI only, and T2WI+DWI of 3.0T magnetic resonance imaging for readers were with sensitivity: 94.59%, 83.78%, 91.89%; with specificity: 66.67%, 77.78%, 72.22% and with accuracy: 85.45%, 81.82%, 85.45%, respectively.
		                        		
		                        			CONCLUSION
		                        			3.0T MRI may have a role in diagnosing muscle invasive bladder cancer following TURBT. T2WI has the advantage of detecting the location of bladder tumor, and DWI has the advantage of differentiating between the benign and malignant lesion. 3.0T MRI T2WI+DWI has a good utility in the detection of muscle invasive bladder cancer following TURBT with satisfied accuracy.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Cystectomy
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Neoplasm Staging
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Urinary Bladder Neoplasms/diagnostic imaging*
		                        			
		                        		
		                        	
8.Computed tomography and magnetic resonance imaging evaluation of pelvic lymph node metastasis in bladder cancer.
Yong LI ; Feiyu DIAO ; Siya SHI ; Kaiwen LI ; Wangshu ZHU ; Shaoxu WU ; Tianxin LIN
Chinese Journal of Cancer 2018;37(1):3-3
		                        		
		                        			BACKGROUND:
		                        			Accurate evaluation of lymph node metastasis in bladder cancer (BCa) is important for disease staging, treatment selection, and prognosis prediction. In this study, we aimed to evaluate the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for metastatic lymph nodes in BCa and establish criteria of imaging diagnosis.
		                        		
		                        			METHODS:
		                        			We retrospectively assessed the imaging characteristics of 191 BCa patients who underwent radical cystectomy. The data regarding size, shape, density, and diffusion of the lymph nodes on CT and/or MRI were obtained and analyzed using Kruskal-Wallis test and χ test. The optimal cutoff value for the size of metastatic node was determined using the receiver operating characteristic (ROC) curve analysis.
		                        		
		                        			RESULTS:
		                        			A total of 184 out of 3317 resected lymph nodes were diagnosed as metastatic lymph nodes. Among 82 imaging-detectable lymph nodes, 51 were confirmed to be positive for metastasis. The detection rate of metastatic nodes increased along with more advanced tumor stage (P < 0.001). Once the ratio of short- to long-axis diameter ≤ 0.4 or fatty hilum was observed in lymph nodes on imaging, it indicated non-metastases. Besides, lymph nodes with spiculate or obscure margin or necrosis indicated metastases. Furthermore, the short diameter of 6.8 mm was the optimal threshold to diagnose metastatic lymph node, with the area under ROC curve of 0.815.
		                        		
		                        			CONCLUSIONS
		                        			The probability of metastatic nodes significantly increased with more advanced T stages. Once lymph nodes are detected on imaging, the characteristic signs should be paid attention to. The short diameter > 6.8 mm may indicate metastatic lymph nodes in BCa.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lymph Node Excision
		                        			;
		                        		
		                        			Lymph Nodes
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Lymphatic Metastasis
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Neoplasm Staging
		                        			;
		                        		
		                        			Pelvic Neoplasms
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			secondary
		                        			;
		                        		
		                        			surgery
		                        			;
		                        		
		                        			Pelvis
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Tomography, X-Ray Computed
		                        			;
		                        		
		                        			Urinary Bladder Neoplasms
		                        			;
		                        		
		                        			diagnostic imaging
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			surgery
		                        			
		                        		
		                        	
9.Intra-abdominal necrotic lipoma diagnosed by computed tomography as a paraprostatic cyst.
Hye Jin KIM ; Su Yeon KIM ; Seong Soo KIM ; Soo Kyung YUN ; Jeo Soon LEE ; Sung Kyun HONG ; Wan Hee KIM ; Yong Baek KIM ; Junghee YOON ; Mincheol CHOI
Journal of Veterinary Science 2017;18(4):559-561
		                        		
		                        			
		                        			A dog with a history of diarrhea and dyschezia exhibited an oval-shaped, soft-tissue opacity mass in the abdomen on radiographs. CT examination revealed a large fluid-filled structure displacing the urinary bladder, prostate, and colon. The mass had continuity with the prostate; therefore, it was tentatively diagnosed as a paraprostatic cyst. Cytologic examination was performed and the mass was considered a non-inflammatory cyst. However, after surgery, histopathologic examination revealed a necrotic, inflamed cystic lipoma. This case shows that unusual intra-abdominal lipomas may have a cystic appearance.
		                        		
		                        		
		                        		
		                        			Abdomen
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Colon
		                        			;
		                        		
		                        			Constipation
		                        			;
		                        		
		                        			Diagnostic Imaging
		                        			;
		                        		
		                        			Diarrhea
		                        			;
		                        		
		                        			Dogs
		                        			;
		                        		
		                        			Lipoma*
		                        			;
		                        		
		                        			Prostate
		                        			;
		                        		
		                        			Urinary Bladder
		                        			
		                        		
		                        	
10.Urinary Continence after Robot-Assisted Laparoscopic Radical Prostatectomy: The Impact of Intravesical Prostatic Protrusion.
Jung Ki JO ; Sung Kyu HONG ; Seok Soo BYUN ; Homayoun ZARGAR ; Riccardo AUTORINO ; Sang Eun LEE
Yonsei Medical Journal 2016;57(5):1145-1151
		                        		
		                        			
		                        			PURPOSE: To assess the impact of intravesical prostatic protrusion (IPP) on the outcomes of robot-assisted laparoscopic prostatectomy (RALP). MATERIALS AND METHODS: The medical records of 1094 men who underwent RALP from January 2007 to March 2013 were analyzed using our database to identify 641 additional men without IPP (non-IPP group). We excluded 259 patients who presented insufficient data and 14 patients who did not have an MRI image. We compared the following parameters: preoperative transrectal ultrasound, prostate specific antigen (PSA), clinicopathologic characteristics, intraoperative characteristics, postoperative oncologic characteristics, minor and major postoperative complications, and continence until postoperative 1 year. IPP grade was stratified by grade into three groups: Grade 1 (IPP≤5 mm), Grade 2 (5 mm
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Laparoscopy/methods
		                        			;
		                        		
		                        			Magnetic Resonance Imaging
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Multivariate Analysis
		                        			;
		                        		
		                        			Postoperative Complications/etiology
		                        			;
		                        		
		                        			Prostatectomy/*methods
		                        			;
		                        		
		                        			Prostatic Neoplasms/complications/*surgery
		                        			;
		                        		
		                        			*Recovery of Function
		                        			;
		                        		
		                        			*Robotic Surgical Procedures
		                        			;
		                        		
		                        			Urinary Bladder Neck Obstruction/*diagnostic imaging/etiology
		                        			;
		                        		
		                        			*Urination
		                        			
		                        		
		                        	
            
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