CT Cystography for Suspicion of Traumatic Urinary Bladder Injury: Indications, Technique, Findings, and Pitfalls in Diagnosis: RadioGraphics Fundamentals | Online Presentation.
Radiographics. 2018 Jan-Feb;38(1):92-93. doi: 10.1148/rg.2018170125. Joshi G1, Kim EY1, Hanna TN1, Siegel CL1, Menias CO1.
Traumatic urinary bladder (UB) injury can occur with blunt or penetrating trauma, most commonly in the setting of motor vehicle collision, and delays in diagnosis are known to increase morbidity and mortality, often from complications of associated uremia, sepsis, peritonitis, metabolic imbalance (from peritoneal reabsorption of urine), and fistula formation.
Computed tomographic (CT) cystography should be considered in patients with pelvic fractures, gross or substantial hematuria (>25 red blood cells per high-power field), hematoma and/or free fluid in the pelvis, or a mechanism of injury with increased likelihood of UB injury. Understanding the indications, as well as the optimal protocol and procedural technique for CT cystography in the acute trauma setting, is critical for efficient and accurate diagnosis (Fig 1). Recognition of procedural, imaging, and interpretive pitfalls at each step during CT cystography is essential to optimally acquire and interpret CT cystographic studies, all of which are reviewed in the online presentation.