基于VI-RADS评分的多参数MRI对膀胱癌术前T分期诊断的临床价值  

Clinical Value of Multi-parameter MRI Based on VI-RADS Score in Preoperative T-stage Diagnosis of Bladder Cancer

作　　者：徐娜 孟庆涛[1] 罗元满 褚雨露 XU Na;MENG Qing-tao;LUO Yuan-man;CHU Yu-lu(Department of Medical Imaging,the First People's Hospital of Chuzhou,Chuzhou 239000,Anhui Province,China;Department of Surgery,Chuzhou City Vocational College,Chuzhou 239000,Anhui Province,China)

机构地区：[1]滁州市第一人民医院医学影像科 [2]滁州城市职业学院外科,安徽滁州239000

出　　处：《中国CT和MRI杂志》2025年第4期143-146,共4页Chinese Journal of CT and MRI

基　　金：安徽省高等学校科学研究项目(2022AH052876)。

摘　　要：目的评价膀胱癌术前T分期诊断中应用基于数据系统(VI-RADS)评分的多参数磁共振成像(MRI)的临床效果。方法回顾性分析2019年1月至2024年4月滁州市第一人民医院接受诊断的81例膀胱癌患者临床资料,术前均行多参数(包括DWI、IVIM、T1WI、T2WI序列)MRI检查,参照VI-RADS对各序列扫描图像进行评分,以病理诊断结果为金标准,分析VI-RADS评分同T分期与MIBC/NMIBC诊断结果的相关性,分析VI-RADS评分对膀胱癌术前T分期诊断的准确率,比较不同VI-RADS评分截断值对肌层浸润性膀胱癌的诊断效能,绘制受试者工作特征(ROC)曲线分析VI-RADS评分诊断肌层浸润性膀胱癌的曲线下面积(AUC)。结果病理结果显示T分期分布:Ta期6例,T1期47例,T2期13例,T3期9例,T4期6例;VI-RADS评分同T分期与MIBC/NMIBC诊断结果存在一定相关性(P<0.05);VI-RADS评分诊断膀胱癌分期的准确率为91.36%,与病理结果的一致性较好(k=0.871);VI-RADS评分≥3分为截断值时,诊断膀胱癌术前T分期的准确度(88.89%),且约登指数最高,为0.893;诊断膀胱癌术前T分期的AUC=0.917(95%CI:0.854,0.976)。结论VI-RADS评分在评估膀胱癌患者进病理状态中临床作用显著,当VI-RADS评分≥3分为截断值时诊断膀胱癌术前T分期的约登指数、准确度最高。Objective To evaluate the clinical effect of multi-parameter magnetic resonance imaging(MRI)based on data system(VI-RADS)score in the preoperative T-stage diagnosis of bladder cancer.Methods The clinical data of 81 bladder cancer patients diagnosed in the First People's Hospital of Chuzhou from January 2019 to April 2024,MRI of multiple parameters(including DWI,IVIM,T1WI,T2WI sequences),each sequential scanned images were scored according to VI-RADS,using the pathological diagnosis result as the gold standard,analysis the correlation between VI-RADS score and T stage and the diagnostic results of MIBC/NMIBC,analyzing the accuracy of VI-RADS score for preoperative T stage diagnosis of bladder cancer,to compare the diagnostic efficacy of different VI-RADS score cutoff values for sarcolecal invasive bladder carcinoma,subject operating characteristic(ROC)curve was drawn to analyze the area under the curve(AUC)of VI-RADS score for the diagnosis of myometrial invasive bladder cancer.Results Pathological results showed T stage distribution:6 cases of Ta stage,47 patients in stage T1,13 in T2,9 patients in stage T3,6 cases in the T4 stage;there was some correlation between VI-RADS score and T stage and the diagnostic results of MIBC/NMIBC(P<0.05);VI-RADS score was 91.36%,good agreement with the pathological results(k=0.871);when the VI-RADS score 3 is classified as a cutoff value,accuracy of preoperative T stage of bladder cancer(88.89%),and the Youden index is the highest,for 0.893;AUC of preoperative T stage for the diagnosis of bladder cancer=0.917(95%CI:0.854,0.976).Conclusion VI-RADS score has a significant role in evaluating the pathological status of bladder cancer patients,with the Youden index and the highest accuracy when VI-RADS score 3 is the cut.

关 键 词：膀胱影响报告和数据系统评分 多参数核磁共振成像 膀胱癌 诊断 

分 类 号：R737.14[医药卫生—肿瘤]