Cystitis glandularis: MR imaging characteristics in 27 patients

Area of Science:

• Urology
• Radiology
• Medical Imaging

Background:

• Cystitis glandularis (CG) is a rare bladder condition.
• Accurate diagnostic imaging is crucial for effective management.
• Magnetic resonance imaging (MRI) offers detailed anatomical visualization.

Purpose of the Study:

• To delineate the diagnostic imaging characteristics of cystitis glandularis (CG) using MRI.
• To identify specific MRI features associated with CG for improved diagnostic accuracy.

Main Methods:

• Retrospective analysis of bladder MRI scans from pathologically confirmed CG patients (January 2019 - November 2023).
• Two experienced genitourinary radiologists evaluated lesion location, morphology, size, signal intensity, and enhancement patterns.
• Analysis included T2-weighted imaging (T2WI), T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI.

Main Results:

• Twenty-seven patients (24 males, median age 47) with CG lesions were analyzed.
• Lesions predominantly occurred in the bladder trigone (18/27) as focal thickening (17/27) or nodules (8/27).
• Characteristic MRI findings included slight hyperintensity on T2WI (sandwich sign in focal thickening), slight hypointensity on T1WI, progressive enhancement on DCE-MRI, and no significant diffusion restriction on DWI.

Conclusions:

• MRI effectively visualizes cystitis glandularis, typically as trigonal thickening or nodules.
• Key MRI features include specific signal intensities on T2WI and T1WI, and progressive enhancement patterns.
• The 'sandwich sign' on T2WI may be a distinctive feature of focal thickening in CG.