Urinary Bladder Neoplastic Masses Findings through Multidetector-Row CT Urography

Abstract

Background: Urinary bladder carcinoma is one of the most common tumors among the lower urinary tract, it is the seventh common malignancy and widely distributed in developed countries. Aim of Study: To elucidate the diagnostic potential and additive imaging data obtained with Multi-Detector Computed Tomography (MDCT) in early detection and characterization of urinary bladder neoplastic masses by comparing the result of the study with the conventional cystoscopy results. Patients and Methods: This prospective descriptive study was conducted on forty patients, 36 was men and 4 women. The patients referred to Radio-Diagnosis Department, Ain Shams University Hospitals, Radio-Diagnosis Department in a period 6 months of data collection for suspicious bladder mass(es) after clinical assessment of patient or for further characterization of indeterminate bladder neoplastic mass lesion previously depicted on other radiological investigation as ultrasound examination. Results: A statistically significant difference was found between positive and negative cystoscopic biopsy results for malignancy in relation to presence CT features of malignancy. Conclusion: MDCT urography is useful for examination of patients especially when the CC is contraindicated such as hemorrhage, perforation, difficult to doing it or unsatisfactory in interpretation, and as a complementary technique in the evaluation of areas difficult to evaluate with CC, especially with the MDCT results satisfactory in finding lesions smaller than 5mm. MDCT urography gives us an opportunity for early detection bladder tumors because its reliability and accuracy and our results support that.

Comparative Study between Pre- and Post-IV Contrast MDCT Urography in Characterization of Neoplastic Urinary Bladder Masses

“…In pre-contrast study, no cases were detected while in post-contrast study 4 cases (13.3%) were found to have pelvic or parailiac lymph node enlargement. As compared to the results of Ola et al, [1] . Regional lymph nodes were identified in post-contrast CT study in 6 out of 30 cases (20%).…”

“…In our study, the perivesical fat stranding was found in 8 cases (26.7%) in post-contrast study that was not properly identified in the pre-contrast study. In the study done by Ola et al, [1] , perivesical fat stranding was found in 11 cases (36.7%) that was also identified in only the post-contrast studies.…”

“…In our study, 17 patients (56.7% of cases) showed irregular wall thickening and 13 lesions (43.3%) to be polypoidal mass lesions on CT in both pre-and post-contrast phases. In a study done by Ola et al, in 2019, only 16 patients out of a total of 40 patients (40%) had irregular urinary bladder wall thickening [1] . In another study performed by Capalbo et al, in 2015, irregular urinary bladder wall thickening showed in 38 cases (21%) and polypoid mass in 72 lesions (40%) of a total of 177 lesions [9] .…”

“…Urinary bladder neoplasms are classified as either epithelial or nonepithelial, with over 95% being epithelial. Urothelial tumors exhibit a spectrum of neoplasia, ranging from a benign papilloma through carcinoma in situ to invasive carcinoma [1] .…”

“…Moreover, it allows the acquisition of multiplanar reformatted images (MPR), which is very similar to that of the axial plane. Combined evaluation by CT cystography, MPR, and virtual images has been shown to increase the effectiveness of the technique, especially for the detection of small lesions [1] . One of the most common procedures in urology is conventional cystoscopy.…”