Kim Jeong Kon, Ahn Jae Hong, Park Taehan, Ahn Han Jong, Kim Chung Soo, Cho Kyoung-Sik
Department of Radiology, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, South Korea.
AJR Am J Roentgenol. 2002 Sep;179(3):763-8. doi: 10.2214/ajr.179.3.1790763.
The objective of this study was to evaluate the usefulness of virtual cystoscopy of the contrast material-filled bladder in evaluating patients with gross hematuria.
Seventy-three consecutive patients who had gross hematuria and whose upper urinary tracts had a normal appearance on single-detector helical CT scans were prospectively evaluated with virtual cystoscopy. Source CT data for virtual cystoscopy were obtained on a multidetector CT scanner with 1.25-mm slice thickness and transferred to a workstation for interactive navigation using volume rendering. Two radiologists independently interpreted the virtual cystoscopic images, and discrepancies were resolved by consensus. All patients also underwent conventional cystoscopy. We assessed the agreement between the findings on virtual and conventional cystoscopy. Using conventional cystoscopy as the gold standard, we evaluated the usefulness of virtual cystoscopy as an aid in identifying bladder lesions and detecting abnormal bladders.
Virtual cystoscopy depicted 60 lesions in the bladders of 43 patients. Fifty-six lesions (in 41 bladders) revealed on virtual cystoscopy were true-positive findings. Four lesions in two bladders with abnormal findings were false-positive. On virtual cystoscopy, the radiologists missed three lesions in two abnormal bladders that were identified on conventional cystoscopy. On virtual cystoscopy, 15 (88%) of 17 lesions smaller than 0.5 cm were identified. The agreement between the findings of virtual and conventional cystoscopy was excellent in the reviewers' identification of bladder lesions (kappa = 0.83) and detection of abnormal bladders (kappa = 0.89). The sensitivity and specificity of virtual cystoscopy were 95% and 87% for identifying bladder lesions and 95% and 93% for detecting abnormal bladders.
Virtual cystoscopy of the contrast material-filled bladder is useful for the evaluation of the bladder in patients with gross hematuria.
本研究的目的是评估对比剂充盈膀胱的虚拟膀胱镜检查在评估肉眼血尿患者中的实用性。
对73例连续出现肉眼血尿且单排螺旋CT扫描显示上尿路外观正常的患者进行前瞻性虚拟膀胱镜检查评估。虚拟膀胱镜检查的源CT数据在层厚为1.25 mm的多排CT扫描仪上获取，并传输至工作站使用容积再现进行交互式导航。两名放射科医生独立解读虚拟膀胱镜图像，分歧通过协商解决。所有患者均接受了传统膀胱镜检查。我们评估了虚拟膀胱镜检查与传统膀胱镜检查结果之间的一致性。以传统膀胱镜检查作为金标准，我们评估了虚拟膀胱镜检查在识别膀胱病变和检测异常膀胱方面的实用性。
虚拟膀胱镜检查在43例患者的膀胱中发现了60个病变。虚拟膀胱镜检查发现的56个病变（在41个膀胱中）为真阳性结果。两个膀胱中发现的4个异常病变为假阳性。在虚拟膀胱镜检查中，放射科医生遗漏了传统膀胱镜检查发现的两个异常膀胱中的3个病变。在虚拟膀胱镜检查中，17个小于0.5 cm的病变中有15个（88%）被识别出来。在评估者对膀胱病变的识别（kappa = 0.83）和异常膀胱的检测（kappa = 0.89）方面，虚拟膀胱镜检查与传统膀胱镜检查结果之间的一致性极佳。虚拟膀胱镜检查识别膀胱病变的敏感性和特异性分别为95%和87%，检测异常膀胱的敏感性和特异性分别为95%和93%。
对比剂充盈膀胱的虚拟膀胱镜检查对评估肉眼血尿患者的膀胱很有用。
