Bladder carcinoma: MDCT cystography and virtual cystoscopy

Bladder carcinoma is the most common tumor among the low urinary tract, accounting for 90% of cancer cases. Conventional cystoscopy represents the gold standard for diagnosis and local management of bladder carcinoma. As the prevalence of transitional cell carcinoma is four-fold greater in men than in women, the endoscopic procedure presents objective difficulties related to the length and bending of male urethra. The most important problems are represented by intense discomfort for the patient and bleeding; furthermore, the high cost, invasivity, and local complications such as infections and mechanical lesions are well-known drawbacks. Additionally, conventional cystoscopy does not provide information about extravescical extensions of the tumor. CT cystography, combined with virtual cystoscopy, is mandatory for TNM staging of the tumor and also is useful when conventional cystoscopy is inconclusive or cannot be performed. We presents the CT cystography combined with virtual endoscopy correlation and bladder carcinoma appearance. © Springer Science+Business Media, LLC 2009

MAGNETIC RESONANCE IMAGING OF THE KIDNEY

This chapter describes the imaging techniques for the examination of the kidney using magnetic resonance (MR), from the fundamental morphologic sequences to the advanced applications. The basic MR features of vascular and infectious renal diseases, solid benign and malignant renal tumors, and cystic renal tumors are described. Advanced MR applications are described as a generai introduction to the following chapters describing the different renal pathologies. Cross-sectional imaging plays a criticai role in the detection and workup of renal pathologies. Even if computed tomography (CT) is stili playing the leader, the role of magnetic resonance imaging (MRI) is increasing, thanks to its better tissue contrast resolution and the absence of radiation exposure. Furthermore, MRI can be used as a problem-solving modality when CT findings are nondiagnostic. While MRI has been shown to be useful in the detection and characterization of renal masses, in the staging of cancers, and in the evaluation of urinary tract anomalies and obstructive disease, attempts are being made to use it for assessment of renal function, such as perfusion, glomerular filtration rate, and intrarenal oxygen measurement. Although the nephrogenic systemic fibrosis has been recently recognized, gadolinium contrast agents are still considered safe. They can be used even in atopic patients and in patients with moderate impairment of renal function (estimateci glomerular filtration rate >30 mL/ min/1.73 m2 )