title: Contrast-enhanced multislice pneumo-CT-cystography in the evaluation of urinary bladder neoplasms.
abstract: OBJECTIVE
  To evaluate the accuracy of contrast-enhanced multislice CT (MSCT) in the study of urothelial tumors after distension of the bladder with air.
  
  
  METHODS
  We evaluated 43 consecutive patients with endoscopically proven bladder lesions. After air distension of the bladder, unenhanced pelvic and enhanced abdomino-pelvic scans were obtained with the following protocol: thickness 2.5mm x 4mm, increment 1mm, scan delay 40'' and 7-10 min. For each patient we considered the number, size, aspect (papillary or sessile) and contrast enhancement of lesions. Ureteral involvement and the presence of synchronous lesions in the excretory scan were also evaluated. MPR and virtual endoscopy images were reviewed in all cases.
  
  
  RESULTS
  Bladder lesions were visualized in 39/43 cases. Compared to conventional cystoscopy, MSCT recognized single lesions in 31/33 patients, two lesions in 4/6, three in 2/2 and more than five foci in 2/2 patients. A papillary aspect was described in 44 cases while 11 lesions were sessile. Conventional Cystoscopy recognized six more lesions as compared with MSCT (four flat and two small papillary lesions). The detection rate for protruding lesions was 100% (52/52) for lesions>5mm and 60% (3/5%) for lesions<5mm. In four patients hydronephrosis was present, while in one case a synchronous lesion was evident in the renal pelvis.
  
  
  CONCLUSIONS
  Contrast-enhanced MSCT with air distension of the urinary bladder is a safe and complete investigation to evaluate the local stage of bladder cancer and to evaluate the ureteral extension of the tumor, as well as the presence of synchronous lesions.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital, Policlinico, Bari, Italy. scardapane@aruba.it
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Scardapane
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pagliarulo
authors.forename: Amato A Stabile
authors.initials: AA
authors.lastname: Ianora
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Pagliarulo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Angelelli
mesh_terms: D003287:Contrast Media; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging*; D014584:User-Computer Interface
chemical_list: D003287:Contrast Media