Evaluating the Diagnostic Performance of Contrast-Enhanced CT in Patients with Clinical Cystitis: A Retrospective Study

Purpose Cystitis is a common urinary tract infection typically diagnosed clinically. Radiological features suggestive of cystitis are frequently observed on computed tomography performed for various abdominopelvic complaints. The diagnostic value of these CT-based findings remains underinvestigated. This study aimed to evaluate the diagnostic performance of contrast-enhanced CT features in clinically confirmed cases of cystitis. Methods This retrospective, single-center study included 269 patients who underwent contrast-enhanced abdominopelvic CT between March 2023 and December 2024. Two radiologists independently assessed CT scans for predefined features, including mucosal enhancement, mural hypertrophy, mucosal irregularity, intraluminal debris, and perivesical fat stranding. Patients were categorized into diagnosed and non-diagnosed groups based on clinical confirmation. Logistic regression and receiver operating characteristic (ROC) analyses were used to evaluate diagnostic performance. A multivariable model was constructed to assess the independent contribution of significant radiological features. Results A total of 130 patients were clinically diagnosed with cystitis, with a mean age of 56.65 years and a predominance of males (61.5%). Perivesical fat stranding (AUC = 0.79), mucosal enhancement (AUC = 0.78), and mural hypertrophy exceeding the upper normal limit (AUC = 0.77) showed strong associations with clinical diagnosis (all p < 0.001) and remained significant in multivariable analysis. In contrast, mucosal irregularity and intraluminal debris showed limited diagnostic value. The combined multivariable model yielded excellent performance (AUC = 0.9316; sensitivity = 83.85%, specificity = 84.89%, accuracy = 84.39%). Conclusions Contrast-enhanced CT features, particularly perivesical fat stranding, mucosal enhancement, and significant mural hypertrophy, demonstrate strong diagnostic value in identifying clinically confirmed cystitis.