Table 2.

Differential Diagnosis of Bladder Wall Thickening.

	Clinical	Lab	US	CT	MRI
Cystitis	Gender: M<F. Most common symptoms: dysuria, frequency, urgency, hematuria. Etiology: Infectious (Bacterial, Tuberculosis, Viral, Fungal). Noninfectious (mechanical, drug-related, radiation-induced).	Leukocyturia, bacteriuria, pyuria, hematuria	Hypoechoic edematous bladder wall.	Usually entire bladder wall thickening +/− hypodense wall. Emphysematous cystitis: gas in the bladder wall and/or lumen.
Non-distention and Trabeculation	Indistinguishable by imaging alone
Bladder Carcinoma	Demographics: 50–60 years of age. Gender: M:F = 4:1 5 year survival rate: 82% in all stages combined. Most common symptom: painless hematuria.	Positive urine dipstick. +/− Micro to normocytic anemia.	Hypo to normoechoic bladder wall thickening or endoluminal soft tissue mass.	Sessile or pedunculated soft tissue mass projecting into the lumen, with similar density to bladder wall. Fine punctate calcifications with tumour. +/− Enlarged metastatic lymph nodes. +/− Extravesical tumour extension.	T1WI: Tumour has intermediate signal intensity, equal to muscle layer of bladder wall. Infiltration of perivesical fat has high signal intensity. T1 C+: Mild early enhancement in primary, perivesical, nodal or bone invasion. +/− Enlarged metastatic lymph nodes. T2WI: Tumour has intermediate signal intensity, higher than bladder wall and lower than urine. Infiltration of perivesical fat has either low or high signal intensity.
Blood Clot	Frequently post-trauma.		Mobile mass, does not cast an acoustical shadow.	Disappear with time, no enhancement	Low signal intensity, no infiltration.
Extrinsic tumour	Rectal, ovarian, vaginal, uterus tumours or fibrosis overlying bladder may simulate bladder wall thickening, mimicking neoplastic involvement.