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Urothelial-phase thin-section MDCT of the bladder in patients with hematuria: added value of multiplanar reformatted images

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic performance of MDCT with axial images and multiplanar reformatted (MPR) images from the urothelial phase of the bladder in patients with hematuria using cystoscopy as the reference standard.

Materials and methods

Our IRB for human investigation approved this study, and informed consent was waived. We included 192 patients (121 men, 71 women; age range 17–90 years; mean age ± SD: 60 ± 14 years) who underwent contrast-enhanced MDCT (scan delay: 70 s; section thickness: 2 mm) and conventional cystoscopy examination for painless gross hematuria or recurrent microscopic hematuria. Two radiologists in consensus interpreted the images for the presence or absence of bladder lesions. Using the kappa statistic, the patient-based agreement was determined between the CT and cystoscopic findings. We compared the diagnostic performance of axial images to those with coronal and sagittal reformations to detect bladder lesions.

Results

MDCT showed excellent agreement between cystoscopy–axial scans (κ = 0.896) and axial with reformatted images (κ = 0.948). The sensitivity, specificity, and accuracy of MDCT were 94%, 96%, and 95% in the axial scans and 98%, 97%, and 97% in the axial with reformatted images, respectively. All statistical parameters of diagnostic performance were similar between the axial and the reformatted images (p > .05).

Conclusion

Axial MDCT imaging demonstrates high diagnostic performance in detecting bladder lesions, but additional reformatted images can improve diagnostic accuracy.

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Acknowledgements

This study was partly supported by a grant from Dasol Life Science, Korea and National Research Foundation of Korea: Basic Science Research Program funded by the Ministry of Education (Contract Grant No. 2018R1D1A1B07048833). We would like to thank Editage (www.editage.co.kr) for English language editing.

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Authors and Affiliations

  1. Department of Radiology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea

    Byoung Hee Han

  2. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea

    Sung Bin Park, Hyun Jeong Park & Eun Sun Lee

  3. Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

    In Ho Chang & Byung Hoon Chi

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  1. Byoung Hee Han
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Correspondence to Sung Bin Park.

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Han, B.H., Park, S.B., Chang, I.H. et al. Urothelial-phase thin-section MDCT of the bladder in patients with hematuria: added value of multiplanar reformatted images. Abdom Radiol 46, 2025–2031 (2021). https://doi.org/10.1007/s00261-020-02819-6

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  • DOI: https://doi.org/10.1007/s00261-020-02819-6

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