Accuracy and Factors Affecting the Outcome of Multi-Detector Computerized Tomography Urography for Bladder Tumors in the Clinical Setting
황의창, 김준석, 김선옥, 정승일, 강택원, 권동득, 박광성, 류수방, 김진웅, Wan Lu Ji,
소속 상세정보
황의창 ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
김준석 ( Kim Jun-Seok )
Chonnam National University Medical School Department of Urology
김선옥 ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
정승일 ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
강택원 ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
권동득 ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
박광성 ( Park Kwang-Sung )
Chonnam National University Medical School Department of Urology
류수방 ( Ryu Soo-Bang )
Chonnam National University Medical School Department of Urology
김진웅 ( Kim Jin-Woong )
Chonnam National University Medical School Department of Diagnostic Radiology
( Wan Lu Ji )
Yanbian Tumor Hospital
KMID : 0358320110520010013
Abstract
Purpose: The objective of this study was to investigate the diagnostic accuracy of multi-detector computerized tomography urography (MDCTU) for the detection of bladder tumors.
Materials and Methods: We retrospectively reviewed the medical records of 143 patients who were scanned by use of 64-channel MDCTU and who underwent cystoscopy due to painless hematuria or a clinical suspicion of bladder tumor. We examined the accuracy of MDCTU for the detection of bladder tumors by comparing the results obtained by MDCTU with those obtained by cystoscopy. The associations between tumor characteristics, frequency of transurethral resection (TUR), and bladder volume and detectability of bladder tumors on MDCTU were also analyzed.
Results: Of 143 patients, 50 patients had a history of urothelial carcinomas. In these patients, the sensitivity and specificity of MDCTU were 60.0% and 80.0%, respectively. In 93 patients without previous urothelial carcinomas, the sensitivity and specificity of MDCTU were 86.7% and 96.8%, respectively. Falsely diagnosed cases had a smaller distended bladder volume (p=0.014) and a smaller tumor size (p=0.022) than did true diagnosed cases. The false-negative rate increased when the bladder tumor was located at the bladder neck. In the univariate analysis, the tumor location, size, frequency of TUR, bladder volume, and initial hematuria were associated with detectability by MDCTU (p<0.05).
Conclusions: To improve the accuracy of MDCTU for diagnosing bladder tumors, bladder filling is recommended. Thus, cystoscopy should be considered as a standard diagnostic tool for bladder tumors even in patients with normal MDCTU results, especially in the evaluation of recurrent, bladder neck-located, small, or sessile bladder tumors.
키워드
Hematuria; Tomography; spiral computed; Urinary bladder neoplasms
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