Diagnostic capability and radiation safety of low dose CT cystography in acute post-traumatic urinary bladder injuries

Abstract

Background: Genitourinary tract injuries occur in up to 5% of all traumas and at least 10% of abdominal traumas. Pelvic fractures are commonly found in patients with blunt trauma, and up to 40% of patients with bladder injuries are associated with at least one other intra-abdominal organ injury. Conventional cystography was the diagnostic modality for suspected bladder injury. Recently CT cystography is commonly used for evaluating bladder injury. For the risk of possible effects of radiation exposure associated with medical imaging procedures, the imaging centers apply the principles of ALARA. Aim of work: We aim to assess the diagnostic capability of low-dose CT cystography in the diagnosis and classification of acute post-traumatic bladder injury. Patients and methods: 44 patients with suspected post-traumatic UB injury were enrolled in this study. Non- and post-contrast CT scan was done using “160” MDCT scanner. Low and standard-dose techniques were applied, and the images were analyzed by two radiologists with at least 15 years of experience. Results: The study involved 44 patients. 20 patients scanned with low-dose CT while 24 patients scanned with the standard technique. Statistically, there was a significant difference between low and standard-dose groups regarding CTDI volume and radiation exposure (p=0.001) with a good diagnostic capability of low-dose CT. Conclusion: Low-dose CT cystography offers a good diagnostic capability of bladder injuries comparable to standard dose CT and may be recommended for the assessment of acute UB injuries.