膀胱影像报告和数据系统联合肿瘤与膀胱壁接触面长度诊断肌层浸润性膀胱癌的价值  

The value of vesical imaging reporting and data system combined with tumor-wall contact length in diagnosing muscle invasive bladder cancer

作　　者：秦彩 田琪 周慧 陈巧玲 李曼曼 鄂天娇 李月玥 王小林[2] 冯峰[1] QIN Cai;TIAN Qi;ZHOU Hui;CHEN Qiaoling;LI Manman;E Tianjiao;LI Yueyue;WANG Xiaolin;FENG Feng(Department of Radiology,the Affiliated Tumor Hospital of Nantong University,Nantong,Jiangsu Province 226000,China;Department of Urology Surgery,the Affiliated Tumor Hospital of Nantong University,Nantong,Jiangsu Province 226000,China)

机构地区：[1]南通大学附属肿瘤医院放射科,江苏南通226000 [2]南通大学附属肿瘤医院泌尿外科,江苏南通226000

出　　处：《实用放射学杂志》2024年第1期64-68,共5页Journal of Practical Radiology

基　　金：南通市社会民生科技项目(MS22021047)。

摘　　要：目的探讨膀胱影像报告和数据系统(VI-RADS)联合肿瘤与膀胱壁绝对接触面长度(ABTCL)及肿瘤与膀胱壁实际接触面长度(ACTCL)诊断肌层浸润性膀胱癌(MIBC)的价值。方法回顾性分析经病理证实的113例膀胱癌(BCa)患者的MRI资料。患者术前均行常规MRI、扩散加权成像(DWI)和动态对比增强(DCE)MRI检查。2名放射科医师依据VI-RADS评分对MRI图像进行评估,并独立测量定量参数,包括ABTCL、ACTCL。采用卡方检验比较MIBC与非肌层浸润性膀胱癌(NMIBC)间VI-RADS评分的差异性;Mann-WhitneyU检验比较MIBC与NMIBC间定量参数的差异性。利用受试者工作特征(ROC)曲线评估VI-RADS、定量参数、VI-RADS联合定量参数诊断MIBC的效能。结果在MIBC与NMIBC之间,VI-RADS、ABTCL、ACTCL的差异均有统计学意义(P<0.05)。ROC曲线分析表明,VI-RADS、ABTCL、ACTCL诊断MIBC的曲线下面积(AUC)分别为0.89、0.76、0.77,ABTCL与ACTCL诊断MIBC的AUC差异无统计学意义(P>0.05);VI-RADS联合ABTCL或ACTCL诊断MIBC的AUC均为0.93,高于单独应用VI-RADS(P<0.05)。结论VI-RADS联合ABTCL或ACTCL均可有效提高诊断MIBC的效能。与曲线测量方法获得的ACTCL相比,直线测量方法获得的ABTCL在临床实践中更易操作。Objective To explore the value of vesical imaging reporting and data system(VI-RADS)combined with absolute tumor-wall contact length(ABTCL)and actual tumor-wall contact length(ACTCL)in diagnosing muscle invasive bladder cancer(MIBC).Methods The MRI data of 113 patients with pathologically confirmed bladder cancer(BCa)were analyzed retrospectively.All patients underwent conventional MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)MRI before surgery.Two radiologists independently evaluated MRI images based on VI-RADS score,and measured quantitative parameters,including ABTCL and ACTCL.The Chi-square test was used to compare the difference of VI-RADS scores between MIBC and non-muscle invasive bladder cancer(NMIBC).Quantitative parameters between MIBC and NMIBC were compared by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of VI-RADS,quantitative parameters and VI-RADS combined with quantitative parameters in the diagnosis of MIBC.Results VI-RADS,ABTCL and ACTCL had significant differences between MIBC and NMIBC(P<0.05).The area under the curve(AUC)for VI-RADS,ABTCL and ACTCL in diagnosing MIBC were 0.89,0.76 and 0.77,respectively.There was no significant difference between the AUC for ABTCL and ACTCL(P>0.05).The AUC for VI-RADS combined with ABTCL or ACTCL in diagnosing MIBC was 0.93,higher than that of only VI-RADS(P<0.05).Conclusion The combination of VI-RADS with either ABTCL or ACTCL can effectively improve the diagnostic performance of MIBC.ABTCL obtainedby linear measurement is easier to implement in clinical practice than ACTCL obtained by curved measurement.

关 键 词：肿瘤与膀胱壁接触面长度 膀胱影像报告和数据系统 肌层浸润 

分 类 号：R694[医药卫生—泌尿科学] R737.14[医药卫生—外科学]