الفهرس | Only 14 pages are availabe for public view |
Abstract Multiphasic CT examination is an accurate method for evaluating patients with cancer bladder that underwent radical cystectomy & urinary diversion. Multiplanar reformatting and three-dimensional volume rendering of multidetector CT image data are particularly useful for achieving an accurate and prompt diagnosis of complications and obtaining information that is essential or adequate surgical management.The diversity of the surgical procedures and of the resultant postoperative anatomic changes makes image interpretation difficult. Familiarity with the normal postoperative anatomy and with optimal CT technique is essential to achieve correct diagnosis. Multidetector CT Urography is a relatively new imaging technique that allows more rapid evaluation of the urinary system. The image data can be transferred to a workstation, allowing multiplanar reformatting and three dimensional (3D) reconstruction. Advantages of multidetector CT Urography over IVU and fluoroscopic loopography include the ability to detect and characterize extraurinary findings (eg, common fluid collections, intestinal complications, tumor recurrence) and to better identify uroepithelial lesions. In addition, multidetector CT is not limited by the body habitus or the presence of abundant stool or intestinal gas, which may hinder evaluation with IVU. Recommendations Multidetector CT Urography should be done for every patient with cancer bladder that underwent radical cystectomy & urinary diversion within the first month post-surgery to detect early complications including small-bowel obstruction, urinary leaks, collections and fistulas then after 6 months followed by annual examination to detect late complications of urinary diversion including ureteral stenosis, herniation, lithiasis, and tumor recurrence. |