总结膀胱平滑肌瘤超声声像图特征及鉴别诊断要点。

分析2000年1月至2016年1月在北京协和医院超声检查并经手术及病理证实为膀胱平滑肌瘤患者的超声声像图特征，探讨膀胱平滑肌瘤定位及定性诊断要点。

17例膀胱平滑肌瘤患者中14例黏膜下型声像图均表现为边界清的低回声肿块，腔内面覆盖线状黏膜高回声，与膀胱腔内高回声黏膜线相延续。3例外膜下型均表现为膀胱旁低回声包块，膀胱受压改变。大体形态上，6例表现为圆形或球状隆起，9例表现为椭圆形占位，2例表现为分叶状；共9例显示出肿物内部或周边条状血流，而其中经阴道超声检查的2例患者均显示出较丰富规则条状血流信号；8例经腹部超声未显示明确血流信号。

膀胱平滑肌瘤以黏膜下型多见，常表现为膀胱壁低回声包块，形态规则，边界清晰，表面可见正常黏膜高回声。外膜下型易误诊，需仔细辨识。超声检查在膀胱平滑肌瘤定位、定性及鉴别诊断中有重要价值，对于女性患者经阴道超声对膀胱平滑肌瘤定位及定性诊断有更明显的优势。

Bladder leiomyoma is a rare type of benign bladder tumors. Because of the lack of knowledge about the ultrasonic patterns of this kind of disease, misdiagnosis frequently happens. Through reviewing the cases and relevant researches, we are able to understand the disease and figure it out in ultrasonic images.

Seventeen cases of patients with bladder leiomyoma were reviewed which were hospitalized in Peking Union Medical College Hospital during 2000 to 2016. All of the patients underwent ultrasound examinations before surgery. Transvaginal ultrasound was performed in 2 cases. And the diagnosis of each patient was confirmed by pathologic findings.

In 14 Submucous leiomyomacases, hypoechoic mass with broad base was found in the bladder, circumscribed by a hyperechoic line, merging with mucous layer of the bladder. Circular shape was found in 6 cases, elliptical shape was in 9 cases, and 2 were lobulated. Blood signals were detected in 9 cases, while 8 cases showed no signals. Abundant regular blood flow was visualized in the 2 cases of transvaginal examinations.

There are some specific characteristics of bladder leiomyoma in ultrasound images, such as elliptical shape, hypoechoic mass with broad base, circumscribed by a hyperechoic line, merging with mucous layer of the bladder, thus it can be diagnosed before surgery by ultrasonography. Moreover, transvaginal ultrasound can provide more information for diagnosis and treatment planning of bladder leiomyoma, playing an important role in the diagnosis of bladder neoplasms.