Ultrasound diagnosis in inverted papilloma of the bladder

Abstract

Objective To explore the ultrasound findings of inverted papilloma of the bladder (IPB).Methods The clinical manifestation,cystoscopy examination,intraoperative observation and ultrasonographic imaging of 24 patients with IPB,which were confirmed by surgery and pathology examination,were analyzed retrospectively.Results 24 patients underwent ultrasound examination and 24 tumors were found.The maximum diameter of tumors were from 1.0 cm to 3.4 cm:1.0-2.0 cm (n =17),2.0-3.4 cm (n =7).Tumors were papillary (n =17) or cauliflower shape (n =7),6 cases had pedicles and none in 18 cases,2 cases swung in the bladder cavity.Tumors were slight hyperecho (n =14) or highlevel echo (n =10),and could be divided into three types:homogenous internal echoes (n =14),inhomogenous internal echoes with punctiform hyperecho in brim or internal part (n =7),inhomogenous internal echoes with peripheral hyperecho and hypoecho in internal part (n =3).Color Doppler flow imaging (CDFI) showed that there were no blood flow signal in 17 cases,punctiform blood flow signal in 4cases,point and strip blood flow signal or strip blood flow signal in 3 cases.Local bladder walls were continuous and there were no attenuation behind the tumors.The onset position were:triangular area (n =6),left posterior wall (n =5),internal urethral orifice (n =4),right lateral wall (n =3),right posterior wall (n =3),posterior wall (n =2),left lateral wall (n =1).5 cases were misdiagnosed as bladder carcinoma,and 17 cases were considered as solid tumors,and only 1 case was diagnosed as papilloma,and 1 case was considered as benign lesion.Conclusions The representative ultrasonographic imaging of IPB are mostly single,pedunculated,papillary or cauliflower shape with smooth surface,neck and trigone of bladder are the most risk position.Color Doppler ultrasonography can be used as the important screening process for IPB. Key words: Ultrasonography; Urinary bladder neoplasms; Papilloma,inverted