방광파열의 진단에서 전산화단층촬영술의 가치와 이용법

Abstract

Purpose: We present our experience with computerized tomography (CT) for diagnosing bladder rupture in patients with blunt abdominal and/or pelvic trauma, and compare the results of CT with those of retrograde cystography. Materials and Methods: We reviewed 52 consecutive cases diagnosed as bladder rupture at our hospital from September 1993 to June 2000. Of them 25 cases underwent retrograde cystography and CT scan simultaneously. After CT scan, post-CT KUB were taken in all cases. Blind readings of CT scans were performed by one radiologist, and the presence or diagnostic accuracy of bladder rupture was evaluated. Results: Of the 25 cases, 21 cases (84%) were accurately diagnosed with CT scan alone. With retrograde cystography, diagnosis was made in 23 cases (92%), and 2 cases had no definite finding of bladder rupture. On post-CT KUB, bowel loop highlighting or perivesical extravasation of contrast media was noted in 20 cases (80%) of 25 cases. This finding also contributed to the diagnosis of bladder rupture and evaluation of upper collecting system. With CT scan, other intra-abdominal injuries were found in 9 cases (36%) and 5 cases of them underwent additional operations. Conclusions: In patients with bladder rupture, evaluation of intra-abdominal injury or upper urinary tract are impossible with retrograde cystography alone. If CT scan is properly performed with pre and post-CT KUB in the initial evaluation, more accurate diagnosis and immediate surgical repair are possible in combination with retrograde cystography. (Korean J Urol 2001; 42:598-602)