rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2015-0-3-31-36rentrad-67Research ArticleСтатьиПоражение треугольника Льето и уродинамические нарушения при раке мочевого пузыря по данным магнитно-резонансной томографииLieutaud’s triangle lesion and urodynamic disorders in bladder cancer according to magnetic resonance imaging dataГригорьевЕ. Г.Grigor'evE. G.

к. м. н., ст. науч. сотр.

MD, PhD, Senior Research Associate

ФроловаИ. Г.FrolovaI. G.

д. м. н., профессор, заведующая отделением лучевой диагностики

MD, PhD, DSc, Professor, Chief of Department of Radiation Diagnosis

ВеличкоС. А.VelichkoS. A.

д. м. н., вед. науч. сотр.

MD, PhD, DSc, Leading Research Associate

ФГБНУ «Томский научно-исследовательский институт онкологии»РоссияTomsk Scientific Research Institute of OncologyRussian Federation201503032016033136Copyright © Григорьев Е.Г., Фролова И.Г., Величко С.А., 20162016Григорьев Е.Г., Фролова И.Г., Величко С.А.Grigor'ev E.G., Frolova I.G., Velichko S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/67

Цель исследования – оценить возможности метода магнитно-резонансной томографии в выявлении опухоли мочевого пузыря в зависимости от размеров и локализации, а также в диагностике сопутствующих уродинамических нарушений.

Материал и методы

Материал и методы. Обследованы 93 пациента (78 мужчин, 15 женщин, средний возраст 62,1±12,2 года) с раком мочевого пузыря. Исследования проводились на 1.5 Т МР-томографе по расширенному протоколу, с обязательным включением в протокол диффузионно-взвешенных изображений; 86 пациентам выполнено внутривенное динамическое  контрастирование.

Результаты

Результаты. У 48,7% пациентов узлы были одиночными, у 51,3% имелось множественное поражение стенок пузыря. У 67,5% пациентов выявлено поражение стенок мочевого пузыря с вовлечением функциональной зоны Льето. При наличии одиночного образования в 58,9% случаев оно локализовалось в треугольнике Льето, множественные поражения локализовались в этой области в 80,5% случаев. Вовлечение в опухолевый процесс устья мочеточника в 68,2% случаев приводило к вторичной уретероэктазии.

Заключение

Заключение. При увеличении количества выявляемых в мочевом пузыре образований вероятность поражения треугольника Льето возрастает. В 26,8% случаев вовлечение в патологический процесс треугольника Льето (p<0,008) сопровождается нарушением уродинамики в виде  уретероэктазии. Показано обязательное применение  внутривенного динамического контрастирования для лучшей визуализации опухоли, определения ее взаимоотношений с подлежащей стенкой и основными структурами мочевого пузыря.

 

 

 

 

Objective

Objective: to estimate the capabilities of magnetic resonance imaging (MRI) in revealing bladder tumor in relation to its sizes and location and in diagnosing concomitant urodynamic disorders.

Material and methods

Material and methods. A total of 93 patients (78 men and 15 women; mean age, 62.1±12.2 years) with bladder cancer were examined. еxaminations were made using 1.5 T MRI according to an extended protocol with a mandatory inclusion of diffusion weighted images; dynamic contrast-enhanced MRI was carried out in 86 patients.

Results

Results. There were single nodules in 48.7% of the patients and multiple bladder wall lesions in 51.3%. Bladder wall injury involving the  functional area of Lieutaud’s triangle was revealed in 67.5% of the patients. Single and multiple tumors in Lieutaud’ triangle were observed in 58.9 and 80.5% of cases. Ureteral orifice involvement led to secondary ureterectasia in 68.2%.

Conclusion

Conclusion. As the number of tumors detected in the bladder increases, the risk of tumors in Lieutaud’s triangle injury rises. The involvement of the triangle into the pathological process is accompanied by impaired urodynamics as ureterectasia in every four cases (26.8%; p < 0.008). It is shown that dynamic contrast-enhanced MRI must necessarily be  performed to better visualize a tumor and to determine its relationships to the underlying wall and basic structures of the bladder.

 

 

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The authors declare that there are no conflicts of interest present.