With development and continued refinement of computed tomography and ultrasonography, considerable advances have been made in the field of diagnostic imaging.
Computed tomography and ultrasonography usually provide accurate localization of pathologic processes of genitourinary tract and frequently contribute information regarding the nature of the process. The areas which were previously "blind" to conventional radiography such as the retroperitoneum and pararenal spaces are now clearly imaged with computed tomography and ultrasonography. The effect on the diagnostic as well as the therapeutic process is seen in daily urologic practice. Treatment planning and patient management can be more efficiently determined using information obtained by computed tomography and ultrasonography. Further percutaneous biopsy, puncture of cyst or nephrostomy placement can often save precious time in the seriously ill patient.
Computed tomography is more expensive than ultrasonography but seems to show the precise anatomic details of the genitourinary tract in a cross sectional fashion.
A review of 59 patients, with suspected genitourinary pathology, studied with computed tomography and ultrasonography performed in the view of the diagnostic accuracy of these methods.
1. Staging of renal cancer with CT (computed tomography) was correct in 6 out of 7 patients who underwent radical nephrectomy.
2. CT staging of renal pelvic cancer was correct in 2 out of 3 operated patients.
3. In evaluating renal mass, sonographic diagnosis was correct in 14 of 16 patients, and CT made correct diagnosis in 20 of 21 patients.
4. CT and ultrasonography were excellent in evaluation of renal injury, in most cases however CT showed the site and extent of injury, extravasation of urine and perirenal hematoma more accurately.
5. Staging of bladder cancer with CT was correct in 4 of 5 patients, failing to differentiate stage A from B, to detect regional lymph node involvement in a patient.
6. CT was useful in detecting lymph node .-involvement of prostatic carcinoma, testicular cancer and penile carcinoma.
7. CT was informative in evaluating impalpable undescended testis, and more adequate if reduced the slice thickness.
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