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Abstract：
Multiple system atrophy is a neurodegenerative disease that affects autonomic and motor systems. Patients with multiple system atrophy usually experience lower urinary tract symptoms, which sometimes appear as an initial symptom before the emergence of the generalized symptoms. An open bladder neck during the filling phase on video urodynamic study is one characteristic imaging finding after the diagnosis of multiple system atrophy, but has not previously been reported at an early phase of the disease. We report a case in which an open bladder neck was observed on several imaging modalities before generalized symptoms emerged. Because occult neurogenic bladder might exist in patients whose lower urinary tract symptoms are resistant to pharmacotherapy, we report this case to raise awareness of the importance of sufficient imaging evaluations. An open bladder neck might be an important imaging finding for diagnosing multiple system atrophy, irrespective of the presence of generalized symptoms. This finding could help avoid false diagnosis and unnecessary treatment.
摘要：
多系统萎缩是一种影响自主神经和运动系统的神经退行性疾病。多系统萎缩患者通常会出现下尿路症状，有时在出现全身性症状之前作为初始症状出现。视频尿动力学研究的充盈期开放膀胱颈是诊断多系统萎缩后的一个特征性影像学发现，但以前没有在疾病的早期阶段报道过。我们报告了一例病例，在出现全身症状之前，在几种成像方式上观察到了开放的膀胱颈。由于隐匿性神经源性膀胱可能存在于下尿路症状对药物治疗有抗性的患者中，我们报告此病例是为了提高对充分影像学评估重要性的认识.开放的膀胱颈可能是诊断多系统萎缩的重要影像学发现，无论是否存在全身性症状。这一发现有助于避免错误的诊断和不必要的治疗。
