Diagnosis of blunt bladder injury: A prospective comparative study of computed tomography cystography and conventional retrograde cystography.
BACKGROUND
This study was designed to evaluate prospectively the accuracy of computed tomography (CT) cystography for the detection of bladder rupture, performed concurrently with screening abdominal/pelvic CT, in patients at risk for blunt bladder injury. The study also aimed to validate our proposed method of performing CT cystography, which was designed to minimize the time and effort required to image the bladder.


METHODS
CT cystography was performed on patients at risk for blunt bladder injury. Retrograde filling of the bladder with dilute iodinated contrast material was performed before routine abdominal/pelvic CT scanning, performed with oral and intravenous contrast. Conventional cystography, when performed, followed CT cystography.


RESULTS
CT cystography, followed by conventional cystography, was performed in 212 patients, among whom 19 had bladder rupture. The CT cystography sensitivity and specificity for bladder rupture in these patients was 95% and 100%, respectively; for conventional cystography, sensitivity and specificity were 95% and 100%, respectively. CT cystography was performed without conventional cystography in 283 patients, among whom 27 had bladder rupture. The sensitivity and specificity of CT cystography for bladder rupture in these patients were both 100%.


CONCLUSIONS
CT cystography is equivalent to conventional cystography for detecting the presence or absence of blunt bladder injury. CT cystography can be performed as an integral part of the CT screening undergone by many blunt trauma patients and, in the vast majority of these patients, it can alleviate the need for a separate conventional cystogram.
Quagliano
Peter V
PV
Department of Radiology, McGuire Veterans Medical Center, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia 23249, USA. qfamiglia@aol.com
Delair
Sean M
SM
Malhotra
Ajai K
AK
D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012421:Rupture / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
D003287:Contrast Media