【影像征象】圣诞树征 | The Christmas tree sign

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【Radiology-Signs in imaging】

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Appearance

A 'Christmas tree' (Fig. 1) has been used to describe the appearance of a hypertonic, neurogenic bladder, as seen on cystography (Fig. 2).
”圣诞树“（图1）用来描述高张神经源性膀胱功能障碍的表现，见于膀胱造影（图2）。

The bladder is vertically oriented and has a wide base that tapers superiorly towards the dome with irregular walls from associated trabeculations.
膀胱方向垂直，宽基底，锥形向上，壁不规则。

图1 圣诞树

图2 AP image from a cystogram shows the opacified elongated bladder with multiple diverticula along the walls.

Discussion

The 'Christmas tree' bladder is most commonly the result of a neurogenic bladder from detrusor hyperreflexia, where there is disruption of the micturition reflex; this can occur at any level in the central nervous system from medulla to lumbar spine.

“圣诞树”膀胱最常见于逼尿肌反射亢进引起的神经源性膀胱，引起排尿反射中断；这可以发生在中枢神经系统从灰质到腰椎的任何水平。

The resultant loss of perception of bladder filling leads to inability to initiate voiding and detrusor-external sphincter dyssynergia.
由此导致的对膀胱充盈的感知丧失导致不能自主排尿和逼尿肌-外括约肌协同失调。

The condition most commonly occurs after spinal cord trauma, but other causes such as multiple sclerosis, myelodysplasia, herniated discs, and arteriovenous malformations have been reported.
这种情况最常见于脊髓损伤后，但其他原因如多发性硬化、骨髓发育不良、椎间盘突出和动静脉畸形也有报道。

It is important to recognize neurogenic bladder dysfunction as patients are at increased risk for urinary tract infection, renal calculi, renal failure, and bladder cancer.
Treatment options include medications, selfcatheterizations, and surgery.
认识到神经源性膀胱功能障碍很重要，因为患者患泌尿道感染、肾结石、肾衰竭和膀胱癌的风险增加。

Treatment options include medications, self-catheterizations,and surgery.
治疗方案包括药物治疗、导尿和手术。

参考文献

  1.Hirshberg B V, Myers D T, Williams T R. The “Christmas tree” bladder[J]. Abdominal Radiology, 2018(5):1-2.

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