Imaging and Urodynamics of the Lower Urinary Tract by Uday Patel

Author:Uday Patel
Language: eng
Format: epub
Publisher: Springer London, London

6.4.3 Computed Tomographic Findings

The primary tumor, if not already excised, may be seen as a mass (Fig. 6.3). In its absence, an area of mild bladder wall thickening may be noted, but this may reflect postbiopsy changes. Tumor enhancement may be seen, usually to a greater degree than the adjacent normal wall, unless the latter is inflamed (Fig. 6.3). Enhancement is greatest within the first 60 s after injection. Multiformatted images (particularly in the coronal plane) are useful for assessing the dome of the bladder (Fig. 5.16). In the absence of artefact, wall thickening implies muscle invasion, but it is impossible to separate T2a from T2b tumors by CT. This is one of the major disadvantages of CT over MRI.

Fig. 6.3An enhanced CT image of bladder cancer. The perivesical fat planes along the right lateral wall are preserved, although the intravesical volume of the tumor is substantial. However, posteriorly (arrow) the fat planes are irregular and this proved to be a T3b stage cancer

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