3-DIMENSIONAL COMPUTED-TOMOGRAPHY OF THE RECONSTRUCTED LOWER URINARY-TRACT - TECHNIQUE AND FINDINGS

The aim of this pilot study in 54 patients was to improve the visualiz ation of the anatomy and postoperative changes in the pelvic topograph y after bilateral ureteroileal urethrostomy, using surface rendering o f electron beam CT (EBCT) data for the 3D display. Fifty-four patients (39 men and 15 women) were scanned with an EBCT unit between 3 and 11 0 months after performing orthotopic ureteroileal urethrostomy (''Hemi -Kock'') or ureteroileal rectosigmoidostomy. Various parameters and sp atial viewing points were used in the 3D reconstruction, which was per formed interactively on external workstations with commercially availa ble software. The anti-reflux nipple was visualized as a distinct stru cture in all patients. In 8 patients with an interval of more than 12 months between surgery and CT, the pouch had developed an ovoid shape almost indistinguishable from the original bladder. The segmented data sets were partly animated to display the anatomy as virtual endoscopy . Three-dimensional depiction and virtual endoscopy of the neobladder using EBCT are a new way of imaging the postoperative anatomy. Its cli nical efficacy in the diagnosis of inconclusive postoperative morbidit y especially voiding problems, and planning of necessary therapy have to be the subject of further evaluation.