Three-dimensional ultrasonography of the urinary bladder: preliminary experience of assessment in patients with haematuria

OBJECTIVE To assess the value of three-dimensional (3D) vs two-dimensional (2D) ultrasonography (US) in the diagnostic evaluation of the urinary bladder in patients with haematuria. PATIENTS AND METHODS In all, 42 patients with painless haematuria and/or irritative voiding symptoms were examined with 2D- and 3D-US. US was done with an Acuson Sequoia unit (Siemens Medical Sol. Mountain View, CA, USA) and the Perspective (R) 3D technique, to assess the presence of bladder lesions, including bladder cancer, bladder wall hypertrophy with trabeculation and diverticula, mucosal bladder folds or re-growth of the prostate mimicking a bladder tumour. The imaging findings were compared with cystoscopy and/ or bladder biopsy. RESULTS In 21 of the 42 patients (50%) cystoscopy with bladder biopsy revealed bladder cancer. Overall, 3D-US gave a correct diagnosis for 36 of 42 patients (86%). All 21 bladder cancers were correctly diagnosed, and 15 (71%) of the 21 benign bladder lesions were correctly identified. By contrast, 2D-US findings gave suspected bladder cancer in all patients. CONCLUSIONS 3D-US is significantly more accurate than standard 2D-US in the diagnostic evaluation of patients with haematuria. Thus, this diagnostic technique might be useful for routine evaluation of the urinary bladder.