Value Of Multi-slice Spiral CT In Preoperative Staging Of Bladder Carcinoma

Objective Through analyzing multi—slice spiral CT imaging performance, comparison of preoperative staging and pathological staging in bladder carcinoma, we can evaluate the role of multi—slice spiral CT imaging performance in preoperative staging of bladder carcinoma, analyze the influence factor of the preoperative staging and improve the method of preoperative staging.Material and Method1.We analyze retrospectively 48 cases bladder carcinoma which inspected in the department of urology surgery of Affiliated Hospital of Qingdao University Medical College in January 2008 to December 2010 period. They all had been carried out with enhanced CT and confirmed by pathology. Those 48 cases bladder carcinoma which were 34 males and 14 females, Age ranges from 36 to 82 years, with an average 57years. There were 40 cases with single focus and others were multi-focus, the total focus were 56. there were 44 cases of painless hematuria,3 cases with single urinary irritation symptoms and 1 cases combined with renal carcinoma. To analyze multi—slice spiral CT imaging performance, comparison of preoperative staging and pathological staging in bladder carcinoma.2. Inspection MethodsSiemens SOMATOM 64-slice CT system, from GermanyMethods:scanning by CT1) Before the examination Patients fasted 8 hours routinely, next patients took 3% Meglucamine diatrizoate 800-1000ml to fill gastrointestinal tract and bladder.2) We first made CT non-contrast enhanced scan of bladder and the scanning area is from lower margin of pubic bone to the level of iliac crest. The heavy layer and thickness distance both were 5mm which will change for 2mm on the location of cancer focus.3) Then we made CT multi-stage contrast enhanced scan with the same scanning area. A loversol-Contrast Agent is used with 300mgl/ml, Total injection with 100ml, Injection rate by 4ml/s.Scanning parameters:Tube voltage 120-140KV, Effective tube current 300mAs,Collimation 5mm,scanning speed 0.5s/360°.Injecting the contrast agent,20-25s later we made the arterial phase enhanced scanning,60-90s later we made the venous phase scanning at the same conditions,3-5min later we made the balanced phase scanning. Patients should be in a state of breath-hold during the scan.3.The CT images were analyzed and diagnosed by two senior radiologists in blind way.Results There were 56 focus, the staging accuracy CT enhanced scan was 90.7% totally. To the focus with in bladder innerwall and that invading the tissue, the staging accuracy were 89.3% and 92.9% respectively, the CT preoperative staging are correlated significantly with postoperative pathology result.Conclusion1.Multi-slice spiral CT has high value in the diagnosis of bladder carcinoma. It would be adopted as a conventional and main examination of bladder carcinoma before operation.2.The preoperative staging accuracy of bladder carcinoma is affected by many factors and has a close relationship with size, location and fundus of bladder carcinoma.