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Type:
Educational Exhibit
Keywords:
Infection, Cancer, Calcifications / Calculi, Cystography / Uretrography, Contrast agent-other, Computer Applications-Detection, diagnosis, Ultrasound-Colour Doppler, CT, Urinary Tract / Bladder
Authors:
S. Nikolova1, K. Nikolov2; 1Skopje/MK, 2Strumica/MK
DOI:
10.1594/ecr2014/C-0520
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 in measuring the extent of the lesion and obtaining virtual images even in patients with severe urethral obstruction and active bleeding.
Limitations are found in the inability to perform biopsy and obtain tissue for histologic examination or to perform endoscopic resection of pedunculated lesions.
As for the sessile lesions or very small polyps (<5 mm),
the virtual CT technique is much less sensitive than conventional cystoscopy.
The possibility of performing follow ups appears to be one of its best advantages.
Virtual CT-pneumocystography can certainly replace conventional cystoscopy in cases with pedunculated lesions when there is no need for biopsy,
when the lesions are located at poorly accessible sites and where cystoscopic instrumentation cannot be introduced into the bladder due to stenosis.
Virtual pneumocystoscopy can also be used in further follow-ups of treated and non treated polypoid lesions in association with other CT modalities.