Department of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea.
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
Abdom Radiol (NY). 2021 May;46(5):2025-2031. doi: 10.1007/s00261-020-02819-6. Epub 2020 Oct 20.
To evaluate the diagnostic performance of MDCT with axial images and multiplanar reformatted (MPR) images from the urothelial phase of the bladder in patients with hematuria using cystoscopy as the reference standard.
Our IRB for human investigation approved this study, and informed consent was waived. We included 192 patients (121 men, 71 women; age range 17-90 years; mean age ± SD: 60 ± 14 years) who underwent contrast-enhanced MDCT (scan delay: 70 s; section thickness: 2 mm) and conventional cystoscopy examination for painless gross hematuria or recurrent microscopic hematuria. Two radiologists in consensus interpreted the images for the presence or absence of bladder lesions. Using the kappa statistic, the patient-based agreement was determined between the CT and cystoscopic findings. We compared the diagnostic performance of axial images to those with coronal and sagittal reformations to detect bladder lesions.
MDCT showed excellent agreement between cystoscopy-axial scans (κ = 0.896) and axial with reformatted images (κ = 0.948). The sensitivity, specificity, and accuracy of MDCT were 94%, 96%, and 95% in the axial scans and 98%, 97%, and 97% in the axial with reformatted images, respectively. All statistical parameters of diagnostic performance were similar between the axial and the reformatted images (p > .05).
Axial MDCT imaging demonstrates high diagnostic performance in detecting bladder lesions, but additional reformatted images can improve diagnostic accuracy.
通过以膀胱镜检查作为参考标准，评估在血尿患者中使用尿路期多排 CT（MDCT）轴位图像和多平面重建（MPR）图像进行诊断的性能。
我们的人体研究伦理委员会批准了本项研究，并且免除了知情同意。我们纳入了 192 例患者（男 121 例，女 71 例；年龄 17-90 岁；平均年龄±标准差：60±14 岁），这些患者因无痛性肉眼血尿或复发性镜下血尿而行增强 MDCT（扫描延迟：70s；层厚：2mm）和常规膀胱镜检查。两位放射科医生对图像进行了阅片，以判断是否存在膀胱病变。采用 Kappa 统计量，确定了 CT 与膀胱镜检查结果之间的患者层面的一致性。我们比较了轴向图像和冠状位及矢状位重建图像检测膀胱病变的诊断性能。
MDCT 在膀胱镜-轴向扫描（κ=0.896）和轴向与重建图像（κ=0.948）之间显示出极好的一致性。轴向扫描时 MDCT 的敏感性、特异性和准确性分别为 94%、96%和 95%，轴向与重建图像时分别为 98%、97%和 97%。轴向与重建图像的诊断性能的所有统计学参数均无显著差异（p＞.05）。
轴向 MDCT 成像在检测膀胱病变方面具有较高的诊断性能，但额外的重建图像可以提高诊断准确性。
