Citation, DOI, disclosures and article data
Cystitis is more common in females due to the short length of the urethra and its close proximity to the anus, predisposing to urinary tract infection 1.
Patients typically present with local symptoms such as suprapubic pain, frequency, dysuria, hematuria, and urgency. In addition, patients may have systemic symptoms like fever, chills, rigors, and fatigue.
Cystitis has a variety of causes 1:
ascending urinary tract infection (most common cause):
bone marrow transplant: may cause hemorrhagic cystitis 2
foreign body: including indwelling catheters
Typical imaging features include 1:
bladder mural hypertrophy: may be diffuse, or less commonly focal; defined as >3 mm when distended or >5 mm when non-distended
urothelial mucosal irregularity
layering intraluminal debris
A bladder neoplasm, foreign body, or diverticulum may be seen in chronic cystitis.
CT or MRI is useful to assess for the presence of a fistula, particularly in the setting of recurrent cystitis.
T2: hyperintense bladder mucosa 3
T1 C+ (Gd): shows increased enhancement of the affected bladder wall (but less enhancement than a bladder neoplasm), also useful in characterizing a bladder abscess
Treatment and prognosis
Antibiotics are the first-line treatment 4.
bladder abscess (may be intramural or exophytic) 1
emphysematous cystitis: gas within the bladder wall, typically seen in diabetic patients 1
Chronic cystitis may result in 5:
transitional cell carcinoma of the bladder: typically demonstrates a focal mass/thickening
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- 2. Zaleska-Dorobisz U, Biel A, Sokołowska-Dąbek D, Olchowy C, Łasecki M. Ultrasonography in the Diagnosis of Hemorrhagic Cystitis - a Complication of Bone Marrow Transplantation in Pediatric Oncology Patients. J Ultrason. 2014;14(58):258-72. doi:10.15557/JoU.2014.0026 - Pubmed
- 3. Tonolini M & Ippolito S. Cross-Sectional Imaging of Complicated Urinary Infections Affecting the Lower Tract and Male Genital Organs. Insights Imaging. 2016;7(5):689-711. doi:10.1007/s13244-016-0503-8 - Pubmed
- 4. Colgan R & Williams M. Diagnosis and Treatment of Acute Uncomplicated Cystitis. Am Fam Physician. 2011;84(7):771-6. - Pubmed
- 5. Wong-You-Cheong J, Woodward P, Manning M, Davis C. From the Archives of the AFIP: Inflammatory and Nonneoplastic Bladder Masses: Radiologic-Pathologic Correlation. Radiographics. 2006;26(6):1847-68. doi:10.1148/rg.266065126 - Pubmed