The Value Of Double-phase Enhancement And Three-dimension Reconstruction With Multiple Detector-row Spiral CT On Clinical Staging Of Preoperative Bladder Cancer

IntroductionBladder cancer is the most common tumor of the urinary tract, accounting for 6 -8% of all male malignancies and 2-3% of all female malignancies. The vast majority of bladder tumors are epithelial in origin, about 90% of them are transitional cell cancers. Accurate preoperative staging not only allows optimal treatment to be selected for the individual patient, but also allows right prognosis to be made. CT is one of the most common methods on examing bladder cancer nowadays. With the development of CT technology, multiple detector - row spiral CT scanner has been widely used in clinical work, it has capabilities of fast scanning, volume rendering and images reconstructing. The three - dimention images after reconstruction can provide us high quality pictures which will show the details of bladder cancer. Images of 3D - CT are showing more and more advantages on preoperative TNM staging of bladder cancer.Materials and MethodsThe study included 32 patients whom were confirmed to suffer from bladder cancer by pathological examination after operation in the First Affiliated Clinical Hospital of China Medical University from November 2004 to February 2006. Preoperative staging were made with GE Lightspeed Ultral 16 multi - slice CT scanner and ADW4. 1 working station in order to select appropriate treatmentand make accurate prognosis for the patients. The clinical TNM staging were made according to the findings of multi - slice spiral CT images which including MPR>Curve and VR before and after administration of contrast medium.The images were read and analyzed by two senior radiologists in double blind way. According to the International TNM Staging Standards of bladder cancer, clinical staging were obtained. The findings of SCT were compared with the post - operative histopathological results. Then, Statistical analyses were made carefully.ResultsThe accuracy of preoperative staging on bladder cancer was 94. 3% by 3D reconstruction of MSCT. When the tumors were confined within the bladder wall ( ^T2b) , the accuracy was 90. 5%. When the tumors had invaded the tissues and organs beyond the bladder wall ( ^ T3 ) , the accuracy was 100%. When bladder cancer metastased from lymph nodes, the accuracy was 88. 2%.Conclusion1. Double - phase enhancement and three dimension reconstruction of MSCT is of great value in clinical staging of bladder cancer because of its extraordinary resolution of space and density.2. It has a very high accuracy on detecting bladder tumor invading peripheral tissues and organs.3. When tumors are within the bladder wall, MSCT is good at differentiating the depth of tumor invasion though it has some limitations.4. In addition, MSCT has capability to detect lymphatic metastasis.