[A comparison between intraurethral echography, computed tomography and magnetic resonance in the staging of bladder...

The purpose of our study was to assess the utility of CT and MRI in the staging of bladder carcinoma. The overall accuracy of MR is in the range of 66 to 85%. T2 weighted and post-Gadolinium T1 weighted images allow one to differentiate T1-T2 from T3a type of neoplasms. Perivesical fat invasion is well shown with T1w images while pelvic wall invasion is better seen on T2w--images. The overall accuracy of CT ranges from 64 to 92%. CT cannot distinguish stage T1 from stage T3a tumors CT is accurate for demonstrating perivesical fat invasion. In the assessment of lymph node metastases CT and MRI have low sensitivity but high accuracy. Trans-urethral sonography is more accurate than CT and MRI in the staging of parietal invasion and it permits the differentiation between T1, T2 and T3a stages even though the distinction between T2 and T3a type of tumors is not always possible. Trans-urethral sonography is not useful in assessing extravesical extension and lymph node metastases. In summary, trans-urethral sonography is the method of choice for evaluating parietal invasion. CT and MR are very accurate for evaluating perivesical fat invasion and are also quite accurate for evaluating lymph nodes. MRI is superior to CT in distinguishing tumors limited to superficial muscle from those that invade deep muscle. MRI can also be helpful in distinguishing the tumor from fibrosis and edema.