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目的：讨论儿童膀胱葡萄状肉瘤的影像诊断和鉴别诊断。方法：６例经手术及病理证实的儿童膀胱葡萄状肉瘤，其中２例进行了ＣＴ检查，４例进行了静脉肾盂造影，１例逆行膀胱造影。作者用双盲法分析儿童膀胱葡萄状肉瘤的影像诊断以及其鉴别诊断。结果：本组２例进行ＣＴ检查病例均见膀胱内多个小的软组织密度结节影，病变位于膀胱颈部、膀胱侧壁和后尿道，１例膀胱壁增厚，前列腺明显增大。膀胱造影表现：３例见膀胱内多个小的充盈缺损，呈葡萄状，１例表现为２个较大的充盈缺损。膀胱葡萄状肉瘤最常发生于膀胱颈部、膀胱三角区，最后可蔓及整个膀胱，根据影像表现分为息肉型和实质型。其ＣＴ表现为：息肉型平扫见肿瘤呈息肉样突入膀胱，其ＣＴ值为软组织密度，膀胱注入造影剂后见大小不一的颗粒状充盈缺损。实质型表现为膀胱壁不规则增厚，并可见壁外的肿块影。膀胱葡萄状肉瘤的膀胱造影表现：息肉型表现为大小不等，边缘光滑锐利的葡萄簇样充盈缺损。实质型由于主要向腔外发展，故膀胱造影可无改变或表现为膀胱壁稍不光滑、僵硬，晚期可呈肿块状充盈缺损。膀胱葡萄状肉瘤主要应与膀胱阴性结石，膀胱内血凝块，膀胱乳头状瘤以及膀胱乳头状癌等相鉴别。结论：作者认为ＣＴ对于检查膀胱葡萄状肉瘤明显优于?
Objective: To discuss the imaging diagnosis and differential diagnosis of bladder urinary sarcoma in children. Methods: Six cases of cystosarcoma of bladder were confirmed by operation and pathology. CT was performed in 2 cases, intravenous pyelography in 4 cases and retrograde cystography in 1 case. The authors used double-blind method to analyze the imaging diagnosis and differential diagnosis of bladder urinary sarcoma in children. Results: Two cases of small soft tissue density nodules in the bladder were found in the two cases of CT examination. The lesions were located in the neck of the bladder, the bladder and the posterior urethra. One case of the bladder wall was thickened and the prostate was significantly enlarged. Bladder angiography: 3 cases see multiple small filling defects in the bladder, showing grapes, 1 case showed two larger filling defect. Bladder grape sarcoma occurs most commonly in the bladder neck, bladder trigone, and finally can spread the entire bladder, according to the image performance is divided into polyps and parenchymal. The CT showed: polypoid flat tumor showed tumor-like polypi into the bladder, the CT value of soft tissue density, the bladder after injection of contrast agent see the size of the filling defect. Substantial performance irregular bladder wall thickening, and visible mass shadow outside the wall. Bladder vitreous sarcoma cystography performance: the performance of the polyp size range, smooth edges and sharp clusters of grape-filled defect. Substantial as the main development to the outside of the cavity, so the cystography can be no change or performance of the bladder wall is not smooth, stiff, advanced tumor was filling defects. Bladder grape-like sarcoma should be mainly negative bladder stones, intra-bladder blood clots, bladder papilloma and bladder papillary carcinoma phase identification. Conclusion: The authors believe CT is superior to bladder gravidar sarcoma test?