Type:
Educational Exhibit
Keywords:
Urinary Tract / Bladder, Abdomen, Oncology, CT, CT-Angiography, Computer Applications-Virtual imaging, Cancer
Authors:
B. Ashraf ahmed1, V. Anusha2, F. Abubacker Sulaiman3, K. SARAVANAN3, V. P. John Pandian3, R. Ravishankar2; 1Melmaruvathur, Tamil Nadu/IN, 2Chennai/IN, 3Melmaruvathur, TN/IN
DOI:
10.26044/ecr2019/C-2802
Findings and procedure details
Detailed history taking,general,
local examination,routine lab investigations such as urine analysis full blood picture and renal analysis to be done.
For cases examined with air contrast in the bladder:-
- The urinary bladder is drained using a catheter and insufflated with 300- 500 ml of room air as per tolerance of the patient.
- A scout view of the bladder obtained and then helical CT scanning will be done using a single- detector row CT scanner with parameters: collimation 3 mm ,
pitch 1,
tube current 250mAs,tube voltage 120 KVP ,7 to 10 mm per second table speed,Images constructed at 1 mm intervals by using appropriate field of view (FOV).Patient examined in both supine and prone position.
For cases examined with non ionic contrast in the bladder:-
- Just pior to scan the patient is asked to empty the bladder by voiding.
CT examination included unenhanced scanning covering entire urinary tract.Intravenous inhection of 80-100 ml of non ionic i contrast into antecubital vein at the rate of 3 ml/sec at dose of 2 ml/kg of body weight.Contrast enhanced scanning covering abdomen and pelvis at adelay of 60-90 seconds.After 2 scans patient is asked to wait for 60-90 minutes and a delay scan done.Scans covering entire urinary bladder taken in supine and prone positions.Virtual cystoscopy done prior to conventional cystoscopy under gereral anesthesia with biopsy specimens for further evaluation.
- Lesions characterized as sessile or polypoidal masses or areas of wall thickening.
- Lesions were characterized as bladder thickening when there was elevation of bladder wall without discrete mass.
- In grossly trabeculated bladder,
small papillary growth may be overlooked ,
so close inspection is required.
- Degree of bladder distension,
amount of urine retained in the bladder after catheterization and overall quality of study (presence of artifacts) will be recorded.