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
Conclusion
Urinary bladder carcinoma is the most common malignat neoplasm of urinary tract.Conventional cystoscopy represents the gold standard for detection of urinary bladder carcinoma.The results of conventional cystoscopy and virtual cystoscopy are comparable for detection of bladder masses.
CTVC provides many advantages:-
- CTVC gives comprehensive information about the bladder tumours.
Images can be stored in file and lesions could be compared in follow up period.
- Access to anterior wall of bladder or lumen of a diverticulum is not restricted by CTVC.
- The technique can be used for diagnosis in a patient who is not candidate for conventional cystoscopy or can be used for the follow up of patients with transitional cell carcinoma,
especially with 100mAs settings.
- CTVC is value for screening,primary diagnosis and surveillance of bladder lesions.It can be indicated as as a clinical routine when convention cystoscopy is contraindicated or restricted in feasibility or interpretion or there is risk of hemorrhage,
perforation or pain in young patients.
CTVC has several limitations:-
- A major one is that it is unable to depict flat lesions,which appear as flat mucousal changes on convention CT.
- Various factors influence detection of sessile lesions.They have an irregular surface that must be minutely depicted in CTVC.
- Differention between small tumours and inflammatory swellings of mucosa is difficult espectially in patients with unsatisfactiry bladder filling.
- Mucosal thickening secondary to fibrosis cannot be distinguished from neoplasm.
- It lacks abilty to provide tissue for histopathology and to identify origin and nature of bladder mass.
- It is diificult to visualise lumen of urethra as is routinely done with conventional cystoscopy.
CTVC may be an alternative or complementary examination where coventionion cystoscopy is contraindicated or difficult.It has been proved also to be useful complementary examination performed between repeated convential cystoscopy examinations in patients with bladder cancer who are undergoing treatment.
It is easily acceptible and could be performed,
when patient refuses for conventional cystoscopy.