Русский
Use of volumetric dynamic voiding multispiral computed cystourethrography in diagnosis and evaluation of treatment efficiency of congenital and acquired pathology of the urogenital area
DOI: https://dx.doi.org/10.18565/urology.2019.5.53-58
A.L. Istranov, I.O. Shchekoturov, R.F. Bakhtiosin, N.S. Serova, R.T. Adamyan, A.V. Matevosyan
1) Department of Oncology and reconstructive surgery of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University), Moscow, Russia; 2) Department of Radiology and radiation therapy of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University), Moscow, Russia
Aim. The aim of this study was to determine the possibilities of volumetric dynamic voiding multispiral computed cystourethrography (VDMMCT) for assessment of the lower urinary tract during voiding.
Materials and methods. VDMMCT was performed in a series of 22 patients with various urethral pathologies using 320 detector rows (640 unique slices; row width 0,5 mm). This method allows to cover the scan area of 16 cm per one rotation of the X-ray tube. In all patients, the cross-sectional area of the various urethral parts was estimated and the urinary bladder volume and average urine flow rate during all voiding phases were calculated.
Results. VDMMCT was performed for dynamic evaluation of bladder volume’s changes and analyzing a passage of contrasted urine throughout the urethra. The average volume of the urinary bladder was 356.3±179.9 ml, while the voiding volume was 299.5±154.8 ml. The average pre- and postoperative urine flow rate was 4.1±1.1 ml/s and 7.9±5.1 ml/s, respectively. The maximum urine flow rate was 19 ml/s. The average urethral diameter according to the VDMMCT after urethroplasty was 7.6±2.1 mm. The minimum length of urethral strictures was 17 mm, while the maximum length was 32 mm.
Conclusion. Our results demonstrate the efficiency of the VDMMCT for assessing of the urethra throughout its length. VDMMCT can multidimensionally and dynamically represent the change of the bladder volume and the urine flow rate.
Materials and methods. VDMMCT was performed in a series of 22 patients with various urethral pathologies using 320 detector rows (640 unique slices; row width 0,5 mm). This method allows to cover the scan area of 16 cm per one rotation of the X-ray tube. In all patients, the cross-sectional area of the various urethral parts was estimated and the urinary bladder volume and average urine flow rate during all voiding phases were calculated.
Results. VDMMCT was performed for dynamic evaluation of bladder volume’s changes and analyzing a passage of contrasted urine throughout the urethra. The average volume of the urinary bladder was 356.3±179.9 ml, while the voiding volume was 299.5±154.8 ml. The average pre- and postoperative urine flow rate was 4.1±1.1 ml/s and 7.9±5.1 ml/s, respectively. The maximum urine flow rate was 19 ml/s. The average urethral diameter according to the VDMMCT after urethroplasty was 7.6±2.1 mm. The minimum length of urethral strictures was 17 mm, while the maximum length was 32 mm.
Conclusion. Our results demonstrate the efficiency of the VDMMCT for assessing of the urethra throughout its length. VDMMCT can multidimensionally and dynamically represent the change of the bladder volume and the urine flow rate.
Keywords: obliteration of urethra, phalloplasty, urethrography, X-ray, dynamic voiding computer cystourethrography, urethral stricture, urethroplasty, multispiral computed tomography
About the Autors
Corresponding author: I.O. Shchekoturov, assistant at the Department of Radiology and radiation therapy of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University), Moscow, Russia; e-mail: samaramail@bk.ru
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