Table of Contents

2014 Month : November Volume : 3 Issue : 60 Page : 13490-13500

ROLE OF USG AND MDCT IN EVALUATION OF URINARY BLADDER MASS

Sunny Goyal1, Tushar Prabha2, Mohan Shivnani3, Ankur Aggarwal4, Hemant Kumar Mishra5

1. P. G. Resident, Department of Radiodiagnosis, Mahatma Gandhi Medical College and Hospital, Jaipur.
2. Senior Resident, Department of Radiodiagnosis, Mahatma Gandhi Medical College and Hospital, Jaipur.
3. Professor, Department of Radiodiagnosis, Mahatma Gandhi Medical College and Hospital, Jaipur.
4. P. G. Resident, Department of Radiodiagnosis, Mahatma Gandhi Medical College and Hospital, Jaipur.
5. Professor and HOD, Department of Radiodiagnosis, Mahatma Gandhi Medical College and Hospital, Jaipur.

CORRESPONDING AUTHOR:
Dr. Sunny Goyal,
Room No. 103, PG Hostel,
MGMCH, Sitapura,
Jaipur-302022.
Email: dr.sunnygoel@gmail.com

INTRODUCTION: Primary bladder neoplasms account for 2%–6% of all tumors, with bladder cancer ranked as the fourth most common malignancy(1). Peak incidence is in the sixth and the seventh decades. Incidence is four times higher in men than in women. The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible (or elastic) organ, the bladder sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra (2). The bladder is readily identified by ultrasound, Computed Tomography, cystography, Magnetic Resonance Image (MRI) and Cystoscopy, but Bladder ultrasound is noninvasive, readily accessible, and easy to use. It has been extensively investigated as a possible substitution for some of the more common invasive modalities used to evaluate the bladder (3).Bladder cancer is the most common tumor of urinary tract. Sonographically, the distended urinary bladder should have smooth, thin, medium level echogenic walls (approximately 3 mm thick) and contain no echoes, with the exception of the normal jets of urine as the ureters empty into the bladder. In the partially filled state, the bladder is collapsed. The urinary bladder cavity is not seen if it is collapsed; otherwise it appears anechoic. The bladder wall appears as a smooth, thin echogenic line. The sonographic appearances of a partially filled bladder are thickened (up to 6 mm thick), irregular walls encircling an echo lucent interior. Therefore, to assess wall thickness, the bladder should be reasonably distended. The ureteral orifices are seen as elevations on the posterior portion of the bladder on longitudinal scans to each side of midline in transverse scans (4).

 

How to cite this article

Sunny Goyal, Tushar Prabha, Mohan Shivnani, Ankur Aggarwal, Hemant Kumar Mishra. Role of USG and MDCT in Evaluation of Urinary Bladder Mass. Journal of Evolution of Medical and Dental Sciences 2014; Vol. 3, Issue 60, November 10; Page: 13490-13500, DOI: 10.14260/jemds/2014/3801

SIGN AND SYMPTOMS

  • Hematuria.
  • Urgency, frequency and strangury.
  • Secondary infections result in cystitis.
  • Tumor at bladder base causes obstructive symptoms.
  • Pain secondary to clot retention into pelvis and urethral obstruction.
  • Constitutional symptoms when distance metastasis occurs.

RISK FACTORS

  • Tobacco smoking.
  • Occupation (exposure to aniline, benzidine and 5naphthylamine).
  • Biological agents (coffee, beer, artificial sweeteners, grilled food).
  • Exposure to radiation, chronic irritation of urothelium
  • Abnormal tryptophan metabolism.

 

AIMS AND OBJECTIVE

  • To Evaluate the role of USG and MDCT in detection of bladder neoplasm
  • To detect the ability of USG and MDCT in staging of malignant neoplasm spread
  • To correlate imaging findings of USG and MDCT with Histopathological findings

 

MATERIALS & METHODS

Study Location: Radio -diagnosis department of Mahatma Gandhi Medical College & Hospital, Jaipur.

Study Design: Prospective analytical study of case records

Study Population: The study was conducted on patients who were referred from urology, surgery and medicine department with complains of hematuria.

Study Period: OCT 2012- Dec2013.

Sample Size: Urinary Bladder cancer cases fromOct2012- Dec 2013.

 

Various types of presentation of bladder mass are as Follows:

  • CASE 1:UNIFOCAL MASS
  • CASE 2:MULTIFOCAL MASS
  • CASE 3: MASS AT APEX
  • CASE 4: MASS AS FOCAL BLADDER WALL THICKNING
  • CASE 5: MASS OBSTRUCTING UVJ CAUSING HYDRONEPHROSIS

 

CASE 1

    

 

CASE 2

 

CASE 3