Corrigan N T, Crooks J, Shand J
Departments of Radiology and Urology, Stobhill General Hospital, Glasgow, UK.
BJU Int. 2000 May;85(7):806-10. doi: 10.1046/j.1464-410x.2000.00631.x.
To determine the use and assess the value of full-bladder films during intravenous urography (IVU) which, despite the widespread availability of flexible cystoscopy, remain part of IVU in many radiology departments. Materials and methods A telephone survey of all Scottish radiology departments where IVU is regularly used showed that half routinely included a full-bladder film in the series. The reports of all IVU over 2 years in the authors' department were analysed retrospectively. The index urogram of all patients with bladder tumours confirmed during this period was reviewed independently by three observers, and together with the initial radiological reports was correlated with the cystoscopic and histological findings.
From 2625 patients, 139 (5.2%) IVU reports commented on the bladder; 1423 patients presented with no haematuria. None of the patients without haematuria, where a comment was made about the bladder, had pathological evidence of a tumour. Overall 121 of 464 (26%) new bladder tumours were diagnosed on IVU before cystoscopy. Multiple tumours were always undetected and large tumours were often overlooked.
Despite its continuing popularity, IVU is a poor means of identifying bladder tumours and routine views of the full bladder should be abandoned.
尽管软性膀胱镜已广泛应用，但静脉尿路造影（IVU）中的全膀胱片在许多放射科仍被使用，本研究旨在确定其使用情况并评估其价值。材料与方法 对所有常规使用IVU的苏格兰放射科进行电话调查，结果显示半数科室在IVU检查系列中常规包含全膀胱片。对作者所在科室两年多来所有IVU报告进行回顾性分析。在此期间确诊的所有膀胱肿瘤患者的索引尿路造影由三名观察者独立审查，并与初始放射学报告一起与膀胱镜检查和组织学结果进行关联。
在2625例患者中，139份（5.2%）IVU报告对膀胱进行了描述；1423例患者无血尿症状。在无血尿且对膀胱有描述的患者中，无一例有肿瘤的病理证据。总体而言，464例（26%）新发膀胱肿瘤中有121例在膀胱镜检查前通过IVU被诊断出来。多发肿瘤总是未被发现，大肿瘤也常常被忽视。
尽管IVU仍很常用，但它在识别膀胱肿瘤方面效果不佳，应放弃常规的全膀胱片检查。
