Learning objectives
Our goal was to evaluate the prospect of future use,
sensitivity and specificity of CT volume- rendering techniques in the evaluation of bladder wall changes,
without the need of conventional endoscopic procedures which is limited by its invasiveness and the difficulty to explore the bladder in full potential.
This study investigates the sensitivity range of virtual CT and 3D reconstruction techniques in assessing lesions of the bladder wall to compare it with that of conventional endoscopy,
and outlines the indications,
advantages and disadvantages of virtual...
Background
30 patients exhibiting signs of hematuria and positive findings at cystoscopy have undergone virtual CT investigation of the bladder in a period of one year,
2013 January- 2013 December.
After an initial ultrasound assessment,
the patients underwent pelvic CT as a single volumetric scan after preliminary air distension of the bladder by means of Foley catheter.
The lesions previously detected at endoscopy were classified as sessile or pedunculated,
and according to size (more or less than 5 mm).
The results obtained at virtual cystoscopy were...
Findings and procedure details
48 lesions (37 pedunculated,
11 sessile) were detected at conventional cystoscopy in 23 patients (multiple polyposis in 7 cases).
Whereas virtual cystoscopy identified 38 lesions (31 pedunculated and 7 sessile).
The undetected lesions were pedunculated <5 mm (6 cases) and sessile (1 case).
Conclusion
The virtual images,
obtained,
were all of good quality.
Some patients have shown painful intolerance to bladder air distension that was overcome.
The overall sensitivity was 72%; thus higher for pedunculated lesions (83%) in comparison to sessile lesions (43%).
The main advantage of the virtual technique is its noninvasiveness and the tendency to be associated with fewer complications.
It also shows great sensitivity in evaluating pedunculated lesions,
as well as anatomically poorly accessible sites such as the bladder base and anterior wall.
It allows accuracy...
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Role of...