Hematuria: Portal venous phase multi-detector row CT of the bladder - A prospective study
Hematuria: Portal venous phase multi-detector row CT of the bladder - A prospective study
复制标题
DOI：
10.1148/radiol.2452061060
复制
发表时间：
2007-12-01
期刊：
影响因子：
19.7
通讯作者：
Cho, Kyoung-Sik
中科院分区：
文献类型：
--
作者：
Park, Sung Bin;Kim, Jeong Kon;Cho, Kyoung-Sik
目的：以膀胱镜检查为参考标准，前瞻性确定门静脉期螺旋多探测器排计算机断层扫描（CT）对血尿患者膀胱病变评估的准确性。材料和方法：该研究已获得人体研究机构审查委员会的批准，并获得所有患者的知情同意。本研究纳入了118名患者（91名男性，27名女性;年龄范围，15-87岁;平均年龄+/-标准差，62岁+/- 14岁），这些患者因无痛肉眼血尿或复发性显微镜下血尿接受了门静脉期多探测器行CT（扫描延迟，70秒;切片厚度，2 mm）和常规膀胱镜检查。两名具有不同经验水平的评审员以前瞻性方式独立评价了膀胱CT病变。使用kappa统计量确定两名审查员之间以及CT和膀胱镜检查结果之间的每处病变和每例患者一致性。多排CT对膀胱病变检测的敏感性和特异性进行了分析，病变的数量和patients.Results的数量：多排CT显示每个病变（kappa = 0.839）和每个患者（kappa = 0.881）之间的两个评论家的协议优秀。在第一位（kappa = 0.866和kappa = 0.881）和第二位（kappa = 0.802和kappa = 0.863）审查者中，CT和膀胱镜检查结果之间的每处病变和每例患者一致性也非常好。两名评审员的多排CT的敏感性和特异性分别为89%-92%和88%-97%，在每病变分析中，分别为95%和91%-93%，在每患者分析中。结论：门静脉期多排螺旋CT对无痛性肉眼血尿和复发性镜下血尿患者的膀胱病变检出具有较高的准确性和阅片一致性，可作为此类患者的首次膀胱检查。
Purpose: To prospectively determine the accuracy of portal venous phase helical multi-detector row computed tomography (CT) for bladder lesion evaluation in patients with hematuria by using cystoscopy as the reference standard.Materials and Methods: The study was approved by the institutional review board for human investigation, and informed consent was obtained from all patients. This study included 118 patients (91 male, 27 female; age range, 15-87 years; mean age +/- standard deviation, 62 years +/- 14) who underwent portal venous phase multi-detector row CT (scanning delay, 70 seconds; section thickness, 2 mm) and conventional cystoscopy because of painless gross hematuria or recurrent microscopic hematuria. Two reviewers with different experience levels independently evaluated the bladder for lesions at CT in a prospective fashion. The kappa statistic was used to determine the per lesion and per patient agreement between the two reviewers and between the CT and cystoscopic findings. The sensitivity and specificity of multi-detector row CT for bladder lesion detection were analyzed for numbers of lesions and for numbers of patients.Results: Multi-detector row CT showed excellent per lesion (kappa = 0.839) and per patient (kappa = 0.881) agreement between the two reviewers. Respective per lesion and per patient agreement between the CT and cystoscopic findings was also excellent in the first (kappa = 0.866 and kappa = 0.881) and second (kappa = 0.802 and kappa = 0.863) reviewers. The sensitivity and specificity of multi-detector row CT were 89% 92% and 88%-97%, respectively, in the per lesion analysis and 95% and 91%-93%, respectively, in the per patient analysis for both reviewers. All statistical parameters of diagnostic accuracy were similar between the two reviewers (P > .05).Conclusion: Portal venous phase multi-detector row CT can provide high accuracy and reader agreement for bladder lesion detection in patients with painless gross hematuria and recurrent microscopic hematuria; these results indicate that multi-detector row CT can be used as the initial bladder examination in such patients.