膀胱癌邻近肌层表观扩散系数值及其比值诊断肌层浸润性膀胱癌的价值  

Application of ADC value and ADC ratio in the diagnosis of muscular invasive bladder cancer

作　　者：夏威利 张孝先 王立峰 许春苗 曲金荣 黎海亮 张首宁 张宏凯 陈学军 XIA Weili;ZHANG Xiaoxian;WANG Lifeng;XU Chunmiao;QU Jinrong;LI Hailiang;ZHANG Shouning;ZHANG Hongkai;CHEN Xuejun(Department of Radiology,the Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院放射科,河南郑州450008

出　　处：《实用放射学杂志》2019年第2期245-248,274,共5页Journal of Practical Radiology

基　　金：河南省科技攻关项目(182102310180).

摘　　要：目的评估3.0T MRI DWI的ADC值及其比值术前诊断肌层浸润性膀胱癌的应用价值。方法 收集经术后病理证实的84例膀胱癌患者的资料,所有患者术前均行包括DWI序列的3.0T MRI检查。以膀胱壁正常肌层作为参照,测量病灶相邻膀胱壁肌层ADC值及正常肌层的ADC值,计算二者的比值,绘制ROC曲线分析膀胱癌病灶相邻肌层的ADC值及其比值与诊断肌层浸润性膀胱癌的关系。结果 测量肌层浸润性膀胱癌病灶相邻肌层的ADC值为(1.36±0.15)×10^-3mm^2/s,ADC比值约为0.69±0.11。绘制ROC曲线分析,当ADC值的阈值为1.52×10^-3mm^2/s时,诊断肌层浸润性膀胱癌的敏感性、特异性均高,分别为92.9%、85.2%;当ADC比值为0.74时,诊断肌层浸润性膀胱癌的敏感性特异性较高,分别为93.5%、89.8%。结论 膀胱癌病灶相邻肌层的ADC值及其比值诊断肌层浸润性膀胱癌有较高的敏感性和特异性,以ADC值1.52×10^-3mm^2/s及ADC比值0.74为阈值诊断肌层浸润性膀胱癌具有较大的应用价值,此阈值可作为术前诊断肌层浸润性膀胱癌的指标,有一定的临床指导意义。Objective To investigate the clinical application of ADC value and ADC ratio of 3.0T MRI DWI in the diagnosis of muscle invasive bladder cancer.Methods 84 consecutive patients with bladder cancer were enrolled in this study.Before surgery,all patients underwent 3.0T MRI examination which included DWI sequence.Ratio of ADC was calculated with normal muscular wall of the bladder as reference site.Measured the ADC value of the adjacent muscular layer of bladder wall and that of the normal muscular layer,and calculated the ratio.Analyzed the relationship between ADC value and ADC ratio,and the diagnosis of muscle invasive bladder cancer by ROC curve.Results The ADC value of muscular layer in muscular invasive bladder cancer was (1.36:[:0.15)× 10^-3 mm^2/s,and the ADC ratio was 0.69±0.11.The sensitivity and specificity of the diagnosis was 92.9 %and 85.2 %respectively when setting ADC value of 1.52 × 10^-3 mm^2/s as the threshold.The sensitivity and specificity of the diagnosis was 93.5%and 89.8%respectively when setting ADG ratio of 0.74 as the threshold.Conclusion The sensitivity and the specificity of ADC value and ADC ratio in diagnosing muscular invasion of bladder cancer are significantly higher.When setting ADC value of 1.52 × 10^-3 mm^2/s and ADC ratio of 0.74 as the threshold,the accuracy of the diagnosis is relatively high.The threshold can be used as an indicator of the preoperative diagnosis of muscular invasive bladder cancer which has the clinical significance.

关 键 词：膀胱癌 磁共振成像 扩散加权成像 表观扩散系数 

分 类 号：R737.14[医药卫生—肿瘤] R445.2[医药卫生—临床医学]