Recognition of bladder tumors by excretory urography.

Abstract

Bladder tumors initially may be diagnosed by excretory urography in patients undergoing the examination because of specific symptoms or unrelated complaints. Among seven strategies tested by six experienced readers, the combination of early, full-bladder, and postvoiding anteroposterior radiographs was most successful in identifying bladder tumors in a series including 20 cases of biopsy-proved bladder tumor and 19 cases of cystoscopically normal bladders. The postvoiding radiograph, when viewed alone, was the single most valuable projection, and resulted in the correct diagnosis of 14 cancers that were not appreciated on any other single radiograph for a given case. The addition of oblique projections to the other three views did not significantly increase diagnostic sensitivity.

Intravenous Urography: Technique and Interpretation

“…examination may constitute the most sensitive imaging sequence for the evaluation of filling defects (Fig 54) (27). Bladder image shows a bladder base defect (arrowheads) similar to that seen in males with prostatic disease ("female prostate" defect).…”

“…If, however, there is specific concern for bladder disease, delayed images may be obtained to improve bladder distention, and oblique, prone, or postvoid images may be obtained to evaluate filling defects (Fig 8) (27). If, however, there is specific concern for bladder disease, delayed images may be obtained to improve bladder distention, and oblique, prone, or postvoid images may be obtained to evaluate filling defects (Fig 8) (27).…”

Urogenital Sistemde Kontrastli Radyografi ve Olgu Ornekleri

“…Pyelogram fazında kaliksiyel yapıların ve toplayıcı sistem üroepitelyumunun değerlendirilmesi yüksek tanısal duyarlılıkla yapılabilmektedir (Resim 9,10 Mesanede duvar kalınlaşması, dolum defekti veya fazlalığı, mukozal asimetri, rezidü-el idrar miktarı gibi parametreler değerlendi-rilebilmektedir [13]. Örneğin üreterovezikal bileşkenin mesane submukozasına protrüz-yon sergilediği üreterosel olgusunda (Resim 13), üreter duvarlarının kontrast maddeyle dolu üreter ve mesane lümeninde radyolusent izlendiği "kobra başı" görünümü ortaya çıkmaktadır.…”

Imaging in Bladder Cancer: Present Role and Future Perspectives

“…A bladder tumor may be recognized as a pedunculated, radiolucent filling defect projecting into the lumen or a focal irregularity of the bladder wall ( fig. 2) [12]. Therefore, IVU remains a method for imaging the detailed anatomy of the pelvicaliceal system and ureters.…”

“…In this case, IVU shows a sensitivity lower than CT. IVU has recently been replaced by CT, especially CTU, in the workup for hematuria and suspected urothelial tumors despite a higher radiation dose. Thus, once the diagnosis of bladder cancer is made, CT or MRI is performed for staging and treatment planning, and routine IVU is generally not indicated [12,13].…”