摘要
Purpose:To describe the imaging characteristics of the upper urinary tract(UUT)in addition to the bladder on computed tomography(CT)in adult patients with late-onset hemorrhagic cystitis(LOHC)after allogeneic hematopoietic stem cell transplantation(HSCT).Subjects and methods:This retrospective study included 24 patients with LOHC who underwent urinary system CT between April 2006 and August 2013.UUT and bladder wall thickness and attenuation were measured before and after contrast material administration.Kidney density,collecting system dilatation,mucosal enhancement,submucosal edema,perivesical stranding around the UUT and bladder,and intravesical clots were evaluated.Diffuse and/or focal renal pelvis and ureter and bladder wall thickening were identified.Correlations between LOHC degree and UUT thickness,UUT attenuation,and uronephrosis were analyzed using Spearman's rank correlation coefficient.Results:Diffuse and/or focal severe UUT and bladder wall thickening was observed in 22 patients(91.7%)with LOHC after HSCT.The median UUT and bladder wall thicknesses(interquartile range)were 2.5 mm(1.0-4.6 mm)and 4.8 mm(3.1-7.3 mm),respectively.Collecting system dilation(17;70.8%),stranding surrounding the UUT and bladder(19;79.2%),and intraluminal clots(two;8.3%)were noted.Three patients underwent ureteral balloon dilation and D-J catheter implantation to resolve irreversible ureteral stenosis and uronephrosis.No significant positive correlation was seen between LOHC classification,UUT wall thickness or attenuation,or uronephrosis(P>0.05).Conclusion:UUT and bladder wall thickening and uronephrosis were observed on CT in patients with LOHC after allogeneic HSCT.Surgical treatment may be needed for irreversible ureteral stenosis.
