多层螺旋CT尿路造影与DCE-MRI对肌层浸润性膀胱癌的诊断价值  

Diagnostic Value of Multi-slice Spiral CT Urography and DCE-MRI in Muscular Invasive Bladder Cancer

作　　者：张宇萌 夏丹丹 邵国庆[1] ZHANG Yu-meng;XIA Dan-dan;SHAO Guo-qing(Xuzhou Central Hospital,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州市中心医院,江苏徐州221000

出　　处：《中国CT和MRI杂志》2023年第12期139-141,共3页Chinese Journal of CT and MRI

基　　金：徐州市临床技术骨干研修计划项目(2020GG015)。

摘　　要：目的探讨多层螺旋CT尿路造影(MSCTU)与动态对比增强磁共振成像(DCE-MRI)对肌层浸润性膀胱癌的诊断价值。方法选取2020年5月至2022年6月诊治的150例疑似膀胱癌患者作为研究对象,以病理结果为金标准,经金标准确诊为膀胱癌共72例,并在金标准确诊前予以多层螺旋CT尿路造影与DCE-MRI扫描,对比两种检查方法与金标准符合情况,计算阳性和阴性预测值,采用ROC曲线模型分析多层螺旋CT尿路造影与DCE-MRI诊断肌层浸润性膀胱癌的AUC值、敏感度及特异度。结果150例疑似膀胱癌患者经MSCTU检查后,阳性和阴性预测值分别为83.58%、80.72%;经DCE-MRI检查后,阳性和阴性预测值分别为94.37%、93.67%。其中,DCE-MRI准确率高于MSCTU(χ^(2)=6.080,P=0.032)。经金标准确诊为膀胱癌患者中,肌层浸润性膀胱癌45例、非肌层浸润性膀胱癌27例;经MSCTU检查后确诊为肌层浸润性膀胱癌共35例,其中T2a占6例、T2b占10例、T3占12例、T4占7例;经DCE-MRI检查后确诊为肌层浸润性膀胱癌共41例,其中T2a占10例、T2b占11例、T3占13例、T4占7例。ROC曲线分析显示,MSCTU、DCE-MRI诊断肌层浸润性膀胱癌的AUC值分别为(0.787、0.947,P<0.05);MSCTU与DCE-MRI的AUC比较,Z=2.432、P=0.014;MSCTU、DCE-MRI诊断肌层浸润性膀胱癌的AUC值分别为(0.787、0.947,P<0.05);MSCTU的AUC值高于DCE-MRI(Z=2.432、P=0.014)。结论MSCTU与DCE-MRI在肌层浸润性膀胱癌诊断中均具有一定价值,其中以DCE-MRI诊断确诊率更高,更有利于评估病灶肌层浸润情况,为临床诊治提供重要参考信息。Objective To evaluate the diagnostic value of multi-slice spiral CT urography(MSCTU)and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in muscular invasive bladder cancer.Methods A total of 150 patients with suspected bladder cancer diagnosed and treated from May 2020 to June 2022 were selected as the study objects.A total of 72 patients were diagnosed with bladder cancer by gold standard based on pathological results.Before diagnosis by gold standard,multi-slice spiral CT urography and DCE-MRI scanning were performed to compare the conformity between the two examination methods and the gold standard.The positive and negative predictive values were calculated,and the AUC value,sensitivity and specificity of multi-slice spiral CT urography and DCEMRI in the diagnosis of myoinvasive bladder cancer were analyzed by ROC curve model.Results After MSCTU examination,the positive and negative predictive values of 150 patients with suspected bladder cancer were 83.58%and 80.72%,respectively.After DCE-MRI examination,the positive and negative predictive values were 94.37%and 93.67%,respectively.The accuracy of DCE-MRI was higher than that of MSCTU(χ^(2)=6.080,P=0.032).Among the patients diagnosed with bladder cancer by gold standard,45 were muscularis invasive bladder cancer and 27 were non-muscularis invasive bladder cancer.A total of 35 cases were diagnosed as myoinvasive bladder cancer by MSCTU examination,of which 6 cases were T2a,10 cases T2b,12 cases T3 and 7 cases T4.A total of 41 cases were diagnosed as myoinvasive bladder cancer by DCE-MRI,of which 10 cases were T2a,11 cases T2b,13 cases T3 and 7 cases T4.ROC curve analysis showed that the AUC values of MSCTU and DCE-MRI in the diagnosis of myoinvasive bladder cancer were 0.787 and 0.947,respectively,P<0.05.The AUC of MSCTU and DCEMRI were compared,Z=2.432 and P=0.014.The AUC values of MSCTU and DCE-MRI in the diagnosis of muscular invasive bladder cancer were 0.787 and 0.947,respectively,P<0.05.The AUC value of MSCTU was higher than that of DCE-MRI

关 键 词：多层螺旋CT尿路造影 动态对比增强磁共振成像 肌层浸润性膀胱癌 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]