640-slice DVCT multi-dimensionally and dynamically presents changes in bladder volume and urine flow rate

Abstract

Abstract. The present study aimed to explore the application of 640-slice dynamic volume computed tomography (DVCT) to excretory cystography and urethrography. A total of 70 healthy subjects were included in the study. Excretory cystography and urethrography using 640-slice DVCT was conducted to continuously record the motions of the bladder and the proximal female and male urethra. The patients' voiding process was divided into early, early to middle, middle, middle to late, and late voiding phases. The subjects were analyzed using DVCT and conventional CT. The cross-sectional areas of various sections of the male and female urethra were evaluated, and the average urine flow rate was calculated. The 640-slice DVCT technique was used to dynamically observe the urine flow rate and changes in bladder volume at all voiding phases. The urine volume detected by 640-slice DVCT exhibited no significant difference compared with the actual volume, and no significant difference compared with that determined using conventional CT. Furthermore, no significant difference in the volume of the bladder at each phase of the voiding process was detected between 640-slice DVCT and conventional CT. The results indicate that 640-slice DVCT can accurately evaluate the status of the male posterior urethra and female urethra. In conclusion, 640-slice DVCT is able to multi-dimensionally and dynamically present changes in bladder volume and urine flow rate, and could obtain similar results to conventional CT in detecting urine volume, as well as the status of the male posterior urethra and female urethra.

A New Technique for Computed-Tomography Urethrography in Males: The Clamp Method

“…administration of contrast to performing CT-VCUG. As for the dose of radiation received by the patient, which is one of the main drawbacks of CT, the mean was 4.96 mSv in our patients with 2 sweeps and 3.456 mSv in those with one sweep, whereas the mean effective dose in the CT-VCUG study [10] was 6.585 mSv, which is in line with the International Commission on Radiological Protection requirements. One of the advantages of urethrography over CT-RUG is that it is a dynamic study that allows filling of the urethral alterations to be visualized in real-time.…”

“…El Kassaby et al [4] first described the CT-UG technique in 2003 and after comparing it to urethrography concluded that CT-UG was more informative in several aspects: the location and the length of the posterior urethral distraction defect, the direction of alignment or misalignment, the bone anatomy (ectopic fragments, callus) and the presence of additional urinary pathology (fistulae, false passages and diverticulae). These advantages of CT-UG have been confirmed in later studies [5,[9][10][11][12][13][14][15]; however, it is still not a widely used technique in clinical practice.…”

“…Some studies report the usefulness of CT-VCUG for evaluating the bladder and posterior urethra [5,9,10]. Chou et al [9] in a study of 13 males with traumatic antecedents reported the diagnostic potential of 3D CT-VCUG after intravenous (i.v.)…”

“…administration of iodinated contrast. Su et al [10] described 3D and 4D CT-VCUG after i.v. the contrast in 70 healthy subjects (43 males and 27 females) using 640-slice dynamic volume CT. Two studies using CT-VCUG [5,9] took a mean time of 8.8 and 9 min (range, 4-20 min) and another performing combined retrograde and voiding CT [11] took a mean time of 10 min (range, 6-20 min).…”

“…A few studies describe the potential diagnosis of CT voiding cystourethrography (CT-VCUG) to assess the bladder and posterior urethra after intravenous administration of iodized contrast [9,10]. However, the CT retrograde urethrography (CT-RUG) technique to evaluate anomalies of the male urethra has barely been reported [11].…”