- “ Multidetector computed tomography (MDCT) cystography is rapidly becoming the most recommended study for evaluation of the bladder for suspected trauma.”
Bladder trauma: multidetector computed tomography cystography
Ishak C, Kanth N
Emerg Radiol (2011)18:321-327 - Bladder Trauma: Facts
Trauma mechanisms
- Blunt trauma (60-85%)
- Penetrating trauma (15-40%)
- Iatrogenic trauma (5%) - Bladder Trauma: Facts
- GU trauma occurs in 5-10% of all patients with trauma
- Bladder injury occurs in 1.6% of blunt trauma cases
- Bladder rupture occurs in 2-11% of patients with pelvic trauma
- However, 60-90% of patients with bladder rupture have a pelvic fracture - Bladder Trauma: Facts
- 70-80% of cases are extraperitoneal rupture
- 15-20% of cases are intraperitoneal rupture
- 5-10% of cases are combined bladder rupture
- intraperitoneal rupture has higher morbidity and mortality
- Calcifications in the Ureter and Bladder: Differential Dx
- TB
- Schistosomiasis
- Alkaline encrusted pyelitis
- Radiation injury
- "Bladder cancer tends to show peak enhancement with the 60-second scanning delay. Multidetector row helical CT is useful in the detection and staging of bladder cancer."
Bladder Cancer: Analysis of Multidetector Row Helical CT Enhancement Pattern and Accuracy in Tumor Detection and Perivesical Staging
Kim et al.
Radiology 2004; 231:725-731
- "Sensitivity and specificity in the diagnosis of perivesical invasion were 89% and 95% respectively, in 67 patients and increased to 92% and 98% respectively, in 44 patients with a time interval of 7 or more days between TURP and CT."
Bladder Cancer: Analysis of Multidetector Row Helical CT Enhancement Pattern and Accuracy in Tumor Detection and Perivesical Staging
Kim et al.
Radiology 2004; 231:725-731
- "The cancer detection rate and positive predictive value for cancer detection was 97% and 95% respectively, in 67 patients and increased to 100% and 100% in 44 patients with a time interval of 7 or more days between TURP and CT."
Bladder Cancer: Analysis of Multidetector Row Helical CT Enhancement Pattern and Accuracy in Tumor Detection and Perivesical Staging
Kim et al.
Radiology 2004; 231:725-731
- Bladder Cancer Enhancement
| Attenuation Value | 40 second scanning delay | 60 second scanning delay | 100 second scanning delay | | Mean plus standard deviation | 75 ± 14 | 106 ± 14 | 84 ± 14 | | range | 55-107 | 78-129 | 55-119 |
Radiology 2004; 231:725-731
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