The role of CT in demonstrating perivesical tumor growth in the preoperative staging of carcinoma of the urinary bladder.

Carcinoma of the urinary bladder was staged both clinically and by CT in 32 patients before they underwent total cystectomy. Eleven of the patients had perivesical growth demonstrated at histopathological examination of the cystectomy specimen. This was diagnosed by CT in all 11 of these patients before cystectomy, but it was discovered by clinical staging in only four patients prior to cystectomy. Seven patients without histopathologically proved perivesical growth were considered to have perivesical spread as demonstrated by CT findings. Three of these patients had perivesical fibrosis that was misinterpreted as perivesical tumor growth, and in all seven patients the perivesical changes were adjacent to the area of present or previous changes in the bladder wall. CT is a valuable addition to clinical staging because it demonstrates perivesical tumor growth.