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La radiologia medica

, Volume 115, Issue 6, pp 920–935 | Cite as

64-Slice CT urography: 30 months of clinical experience

  • P. Martingano
  • F. Stacul
  • M. Cavallaro
  • F. Casagrande
  • S. Cernic
  • M. Belgrano
  • M. Cova
Uro-Genital Radiology / Radiologia Uro-Genitale

Abstract

Purpose

This study sought to assess the diagnostic accuracy of 64-slice computed tomography urography (CTU) in evaluation of the urinary tract.

Materials and methods

A total of 322 CTU procedures were carried out in 317 consecutive patients (mean age 64.4 years). The findings were compared with previous and subsequent patient workup considering both laboratory and imaging studies, such as urine cytology, abdominal ultrasound and CT, cystoscopy, retrograde pyelography, surgery and pathology.

Results

Out of 322 CTU examinations, 169 showed significant urinary tract changes, whereas 153 revealed no urinary disease, in good agreement with the follow-up. In particular, in bladder evaluation, for which we have a direct comparison with cystoscopy in 125 patients, we calculated a CTU sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 85%, 94%, 92%, 89% and 90%, respectively.

Conclusions

CTU was accurate for urinary tract evaluation, but it cannot replace cystoscopy in patients in whom a malignant bladder disease is suspected.

Keywords

Multislice computed tomography CT urography Urinary tract Kidney Bladder 

Uro-TC con apparecchiatura a 64 strati: 30 mesi di esperienza clinica

Riassunto

Obiettivo

Scopo del nostro lavoro è stato valutare l’accuratezza diagnostica dell’uro-tomografia computerizzata (TC) eseguita con apparecchiatura a 64 strati nella valutazione delle patologie della via escretrice.

Materiali e metodi

Sono stati effettuati 322 esami uro-TC su 317 pazienti consecutivi (età media 64,6 anni). L’esito è stato confrontato con il precedente e successivo iter diagnostico seguito dal paziente, tenendo in considerazione sia gli esami laboratoristici e strumentali, quali citologia urinaria, ecografia e TC addominale, cistoscopia, cistouretrografia retrograda, sia gli eventuali interventi chirurgici con relativa diagnosi istologica.

Risultati

Tra le 322 uro-TC eseguite, 169 hanno individuato significative alterazioni a carico dell’apparato urinario e 153 non hanno evidenziato aspetti di rilievo, con buona concordanza al follow-up. In particolare a livello vescicale, ove possediamo in 125 pazienti un riscontro diretto dei reperti mediante cistoscopia, abbiamo rilevato un valore di sensibilità dell’85%, una specificità del 94%, un valore predittivo positivo del 92%, un valore predittivo negativo dell’89%, per una accuratezza diagnostica del 90%.

Conclusioni

L’uro-TC si è dimostrata un esame accurato per lo studio della via escretrice, ma non può sostituirsi all’esecuzione di un esame cistoscopico nello studio dei pazienti con sospetta patologia neoplastica vescicale.

Parole chiave

Tomografia computerizzata multistrato Uro-TC Via escretrice urinaria Rene Vescica 

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Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • P. Martingano
    • 1
  • F. Stacul
    • 2
  • M. Cavallaro
    • 1
  • F. Casagrande
    • 1
  • S. Cernic
    • 1
  • M. Belgrano
    • 1
  • M. Cova
    • 1
  1. 1.U.C.O. di Radiologia, Ospedale di CattinaraAzienda Ospedaliero-UniversitariaTriesteItaly
  2. 2.S.C. di Radiologia, Ospedale MaggioreAzienda Ospedaliero-UniversitariaTriesteItaly

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