Application value of 64 multi-detector helical CT for diagnosis of small bladder tumor

Objective: To evaluate the application value of 64-multi detector spiral CT (64-MSCT) in the diagnosis of small bladder tumor. Methods: Forty-eight patients with small bladder tumor (≤ 1.5 cm) were re-checked by bladder axial scans of 64-MSCT, arterial phase, venous phase, delayed phase enhancement scanning and multi planar reconstruction (MPR)reprocessing. CT imaging data were analyzed retrospectively. Results: Among the 48 cases of small bladder tumor, 45 cases were detected through bladder axial scans of 64-MSCT, with the positive rate of 93.75%, and 3 cases were not detected, with the miss rate of 6.25%. While 48 cases were detected through bladder axial scans of 64-MSCT, arterial phase, venous phase and delayed enhancement scanning, the positive rate was 100%. The application of MPR reprocessing is favorable to the location of small bladder tumor. Among the 48 cases of small bladder tumor, 44 cases occurred on walls of urinary bladders, and 4 cases in vesical diverticulum. All the cases were confirmed by surgery and pathology. Among the 48 cases of small bladder tumour, 2 cases were demonstrated as carcinoma in situ, 6 cases as adenocarcinoma, 38 cases as transitional cell carcinoma, and 2 cases as papillary epithelioma. The signal intensities of small nodular soft tissues with the papillary or cauliflower-like structures were shown by axial scans of 64-MSCT, and uniform and constant reinforcement were appeared in delayed enhancement scanning. Six cases of narrow base pedunculated lesions were diagnosed as papillary epithelioma by 64-MSCT, while 2 cases were confirmed as papillary epithelioma, and 4 cases as transitional cell carcinoma by pathology. Four cases were misdiagnosed by 64-MSCT, with the misdiagnosis rate of 66.67%. There is some difficulty in differential diagnosis of 64-MSCT on narrow base pedunculated lesions. The accuracy rate of diagnosis of small bladder tumor by 64-MSCT was 89.59%, and the rate of misdiagnosis was 10.41%. Conclusion: 64-MSCT can meet the needs of detection and diagnosis of small bladder tumor, and may be an ideal method for the non-invasive diagnosis of small bladder tumor. (authors)