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Imaging Findings of Hemorrhagic Cystitis in Pediatric Oncology Patients
Imaging Findings of Hemorrhagic Cystitis in Pediatric Oncology Patients
Imaging Findings of Hemorrhagic Cystitis in Pediatric Oncology Patients
b
b Fig. 2 a, b This 14-year-old boy underwent bone-marrow trans-
plantation for aplastic anemia. a Transverse color Doppler sono-
gram of the bladder shows focal area of active bleeding from the
anterior bladder wall (arrow). b Cystoscopic photograph shows fo-
cal hemorrhagic mucosa in an area corresponding to the focus of
bleeding revealed by color Doppler sonography
a b
c d
7 8
9 10
11
Fig. 7 This 10-year-old girl developed hemorrhagic cystitis after (TR/TE, 550/15) MR image shows that the bladder is filled with
bone-marrow transplantation. Her bladder perforated after sclero- clot. Methemoglobin (white arrow) appears bright, and deoxyhe-
therapy. CT image of the pelvis after repair of the bladder perfora- moglobin(open arrow) appears dark. Note that the muscular layer
tion shows the bladder to be distended by clot. The positions of the of the bladder wall (black arrows) and the intraluminal clot can
bilateral ureteral stents (curved arrow), suprapubic Foley catheter be visualized separately
(open arrow) and transurethral Foley catheter (straight black ar- Fig. 10 This 19-year-old boy underwent bone-marrow transplanta-
row) suggest that there is probably intramural hemorrhage or tion and was later treated for hemorrhagic cystitis. Longitudinal
thickening as well as intraluminal clot
sonogram of the right kidney shows suburothelial edema and
Fig. 8 This 12-year-old girl was treated with intravesical silver ni- thickening (arrow)
trate and formalin for hemorrhagic cystitis. Transverse sonogram Fig. 11 This 10-year-old girl underwent bone-marrow transplanta-
shows that the bladder is distended by clot. Note difficulty in dis-
tion and was later treated for hemorrhagic cystitis. Longitudinal
tinguishing the bladder wall sonogram of the right kidney shows subcapsular fluid collection
Fig. 9 This 15-year-old boy underwent bone-marrow transplanta- (arrows) that may be due to hemorrhage or forniceal rupture in a
tion and was later treated for hemorrhagic cystitis with two intra- fragile and obstructed collecting system
vesical installations of 0.5 % silver nitrate. Coronal T1-weighted
137
b
Fig. 12 a±c This 15-year-old boy underwent bone-marrow trans-
plantation and was later treated for hemorrhagic cystitis. a Longi-
tudinal sonogram of the right kidney shows the calyces to be filled
with debris (arrows). b Coronal T1-weighted (TR/TE, 559/15) im-
age of the kidneys shows mixed high- and low-signal material in
the right renal collecting system consistent with hemorrhage and
possibly papillary necrosis. c Image obtained during nephrostomy
tube placement shows large amount of debris in collecting system
(open arrows). The location of filling defects in calyces (black ar-
rows) is consistent with papillary necrosis. The obstructed proxi-
mal ureter (white arrow) is probably due to sloughed debris and
blood clot
to the bladder, the kidneys in patients with hemorrhag- imaging be performed for patients suspected of having
ic cystitis must be evaluated. We recommend that re- hemorrhagic cystitis and in the follow-up of those who
nal/bladder 2D and power Doppler ultrasound are treated for this disease.
References
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