高、低场强多参数MRI膀胱影像报告与数据系统对膀胱癌浸润肌层诊断效能的比较

The diagnostic efficacy of vesical imaging reporting and data system in the diagnosis of musclar invasiveness of bladder cancer:comparison between 1.5T and 3.0T multiparametric MRI

目的:对比1.5T和3.0T多参数MRI(mp-MRI)膀胱影像报告与数据系统(VI-RADS)对膀胱癌浸润肌层的诊断效能。方法:回顾性分析行mp-MRI检查且经病理证实的193例膀胱癌患者(共217个病灶)的病例资料,其中92例(101个癌灶)采用1.5T MR(1.5T组)、101例(116个癌灶)采用3.0T MR(3.0T组)行mp-MRI检查。两位影像科医师在不知病理结果的情况下,根据VI-RADS对T 2WI、DWI及动态增强(DCE)图像进行盲法阅片及评分。1.5T与3.0T两组的VI-RADS评分对膀胱癌浸润肌层的诊断效能采用受试者工作特征(ROC)曲线进行分析。结果: 1.5T和3.0T两组VI-RADS评分诊断膀胱癌浸润肌层的阈值均为≥4,相应的曲线下面积(AUC)分别为0.907和0.942,敏感度分别为79.0%和87.5%,特异度分别为87.8%和95.2%,阳性预测值分别为60.0%和87.5%,阴性预测值分别为94.7%和93.1%,准确度分别为86.1%和93.1%。结论: VI-RADS评分在高、低场强mp-MRI中对膀胱癌浸润肌层均有较高的诊断价值,且3.0T的诊断效能优于1.5T。

Objective: To compare the diagnostic efficacy of Vesical Imaging Reporting and Data System (VI-RADS) using 1.5T and 3.0T multiparametric MRI (mp-MRI) for the diagnosis of muscular invasiveness of bladder cancer. Methods: The clinical data of 193 patients (217 tumors in total) pathologically confirmed bladder cancer were retrospectively analyzed.All the patients underwent mp-MRI examinations (92 patients with 101 tumors performed at 1.5T scanner;101 patients with 116 tumors performed at 3.0T scanner).T 2-weighted imaging,diffusion weighted imaging and dynamic contrast enhanced imaging were reviewed and scored according to VI-RADS by two radiologists with blind method.Receiver operating characteristic (ROC) analysis was performed to determine the diagnostic efficacy for the differentiation of non-muscle invasive bladder cancer from muscle invasive bladder cancer. Results: The threshold value of VI-RADS score in the diagnosis of muscular invasiveness of bladder cancer in both groups (1.5T and 3.0T group) was ≥4.ROC analysis showed that the corresponding area under curve (AUC) in 1.5T and 3.0T group was 0.907 and 0.942,diagnostic sensitivity was 79.0% and 87.5%,specificity was 87.8% and 95.2%,positive predictive value (PPV) was 60.0% and 87.5%,negative predictive value (NPV) was 94.7% and 93.1%,and accuracy was 86.1% and 93.1%,respectively. Conclusion: Both 1.5T and 3.0T mp-MRI using VI-RADS perform well for diagnosing muscular invasiveness of bladder cancer,and 3.0T shows higher diagnostic efficacy than 1.5T.