Panebianco V, Osimani M, Lisi D, Santucci E, Ciccariello M, Iori S, Catalano C, Passariello R
Dipartimento di Scienze Radiologiche, Policlinico Umberto I, Sapienza Università di Roma, Viale Regina Elena 324, 00161, Roma, Italy.
Radiol Med. 2009 Feb;114(1):52-69. doi: 10.1007/s11547-008-0350-x. Epub 2008 Dec 11.
This study was conducted to evaluate the role of computed tomography cystography (CTC) and virtual cystoscopy (VC) with 64-slice CT in diagnosing bladder lesions using flexible cystoscopy as the reference standard.
Twenty-eight patients with suspected bladder cancer and ten patients who had undergone transurethral resection of the bladder were studied by CTC and VC in both the supine and prone positions after distending the bladder with air. The patient population was divided into three groups based on lesion size at flexible cystoscopy. Results of the CT study were compared with those of flexible cystoscopy.
Flexible cystoscopy depicted 88 bladder lesions in the 38 patients examined. Sensitivity and specificity values of CTC and VC alone were constantly lower than those of the combined-approach (group 1: 93.10% and 92.31%; group 2: 100% and 100%; group 3: 100% and 100%, respectively). Receiver operating characteristic (ROC) curve analysis showed that the combined approach decreases the lower dimensional threshold for lesion detection (1.4 mm).
VC and CTC with 64-slice CT are promising diagnostic techniques for bladder cancers measuring 1-5 mm. Further studies on larger patient populations are required to validate our results.
本研究旨在以软性膀胱镜检查为参考标准，评估64层CT尿路造影（CTC）和虚拟膀胱镜检查（VC）在诊断膀胱病变中的作用。
对28例疑似膀胱癌患者和10例接受过膀胱经尿道切除术的患者，在膀胱充气扩张后，分别采用仰卧位和俯卧位进行CTC和VC检查。根据软性膀胱镜检查时的病变大小，将患者人群分为三组。将CT检查结果与软性膀胱镜检查结果进行比较。
在接受检查的38例患者中，软性膀胱镜检查发现了88个膀胱病变。单独使用CTC和VC的敏感性和特异性值始终低于联合检查方法（第1组分别为93.10%和92.31%；第2组分别为100%和100%；第3组分别为100%和100%）。受试者操作特征（ROC）曲线分析表明，联合检查方法降低了病变检测的较低维度阈值（1.4毫米）。
64层CT的VC和CTC对于测量1 - 5毫米的膀胱癌是有前景的诊断技术。需要对更多患者人群进行进一步研究以验证我们的结果。
