磁共振扩散加权成像在膀胱癌中的应用价值研究  

Application value of diffusion weighted imaging in bladder cancer

作　　者：杨晓亮 李亚杰 杨晓波[2] YANG Xiaoliang;LI Yajie;YANG Xiaobo(Department of Surgery,Traditional Chinese Medicine Hospital of Lingwu,Yinchuan 751400,China;General Hospital of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏灵武市中医医院外科,宁夏银川751400 [2]宁夏医科大学总医院,宁夏银川750004

出　　处：《宁夏医学杂志》2023年第8期688-690,共3页Ningxia Medical Journal

摘　　要：目的探讨磁共振成像(MRI)结合扩散加权成像(DWI)在膀胱癌(BCa)诊断中的应用价值并比较不同部位表观扩散系数(ADC)。方法选取收治的膀胱癌患者146例为研究对象,均行常规MRI、DWI检查,以病理结果为金标准,分析MRI结合DWI对膀胱癌诊断的应用价值,同时比较不同区域ADC值。结果DWI诊断膀胱癌的敏感度、特异度和准确度分别为90%、80%和88%。膀胱癌、膀胱炎症、病灶周围膀胱壁和尿液的平均ADC值分别为(0.61~1.27)×10^(-3)mm^(2)/s、(1.37~1.66)×10^(-3)mm^(2)/s、(1.29~1.56)×10^(-3)mm^(2)/s、(2.26~2.85)×10^(-3)mm^(2)/s,BCa与癌旁膀胱壁、BCa与膀胱内储存的尿液、BCa与膀胱炎症的平均ADC值之间比较差异均有统计学意义(P<0.05)。DWI区分非肌层浸润性膀胱癌(NMIBC)和肌层浸润性膀胱癌(MIBC)的敏感度、特异度和准确度分别为91%、69%和88%。高分级与低分级膀胱尿路上皮癌的平均ADC值分别为(0.75±0.15)×10^(-3)mm^(2)/s和(1.15±0.19)×10^(-3)mm^(2)/s,两者比较差异有统计学意义(P<0.05)。结论MRI结合DWI在膀胱癌临床分期中有较高诊断效能,其中ADC值可反映不同的膀胱癌分级。Objective To investigate the value of MRI combined with DWI in the diagnosis of bladder cancer and to compare the ADC at different sites.Methods A total of 146 patients with bladder cancer were selected as the research objects,all of whom underwent routine MRI and DWI examinations,and the pathological results were used as the gold standard to analyze the application value of MRI combined with DWI in the diagnosis of bladder cancer,and compare the ADC values in different regions.Results The sensitivity,specificity and accuracy of DWI in the diagnosis of bladder cancer were respectively 90%,80%and 88%.The average ADC values of bladder cancer,bladder inflammation,bladder wall around the focus and urine were(0.61~1.27)×10^(-3)mm^(2)/s,(1.37~1.66)×10^(-3)mm^(2)/s,(1.29~1.56)×10^(-3)mm^(2)/s and(2.26~2.85)×10^(-3)mm^(2)/s,the average ADC value between bladder cancer and the bladder wall around the focus,between bladder cancer and urine,and between bladder cancer and bladder inflammation were statistically significant(P<0.05).The sensitivity,specificity and accuracy of DWI in differentiating NMIBC and MIBC were respectively 91%,69%and 88%.The average ADC values of high-grade and low-grade bladder urothelial carcinoma were(0.75±0.15)×10^(-3)mm^(2)/s and(1.15±0.19)×10^(-3)mm^(2)/s,the difference between them was statistically significant(P<0.05).Conclusion MRI combined with DWI has high diagnostic efficiency in clinical staging of bladder cancer,and ADC value can reflect different grades of bladder cancer.

关 键 词：磁共振 膀胱癌 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]