膀胱癌核磁图像-数据系统评分评估膀胱癌肌层的浸润状态

VI-RADS scoring system can predict muscle-invasiveness of bladder cancer

目的评估膀胱癌的核磁图像-数据系统(VI-RADS)预测肌层浸润性膀胱癌的诊断效能。方法回顾性搜集2013年10月至2018年5月期间确诊为膀胱尿路上皮癌并行手术治疗的患者临床资料,按照VI-RADS评分准则对3个核磁序列(T2加权图像、弥散加权图像和动态增强图像)进行评分并计算最终分值。受试者工作特征(ROC)曲线和曲线下面积(AUC)用于评估VI-RADS的诊断能力。通过采取临界值,计算VI-RADS评分预测肌层浸润性膀胱癌的敏感性、特异性和准确性。结果共有166例患者纳入本研究。各VI-RADS评分病灶数为:VI-RADS 1有16例(9.6%),VI-RADS 2有98例(59.0%),VI-RADS 3有18例(10.9%),VI-RADS 4有14例(8.4%),VI-RADS 5有20例(12.1%)。VI-RADS评分预测肌层浸润性膀胱癌的AUC值为0.886(0.825~0.947),敏感性、特异性和准确性分别为80.4%(66.5%~89.7%)、90.4%(83.2%~94.9%)和87.3%(84.8%~89.9%)。Logistic回归分析明确VI-RADS评分≥3是肌层浸润性膀胱癌的独立危险因素。结论VI-RADS评分系统能较准确地评估膀胱癌的肌层浸润状态,推荐将该评分应用于常规的术前评估。

ObjectiveTo explore the Vesical Imaging-Reporting and Data System(VI-RADS)in the prediction of muscle-invasiveness of bladder cancer.MethodsClinical data of confirmed urothelial carcinoma of bladder cases treated during Oct.2013 and May 2018 were retrospectively analyzed.The T2 weighted image(T2WI),diffusion weighted imaging(DWI)and dynamic contrast enhancement(DCE)sequences were scored with VI-RADS and the final scores were calculated.The diagnostic capacity of VI-RADS score was determined with receiver operating characteristic(ROC)curve and area under the curve(AUC).The sensitivity,specificity and accuracy of VI-RADS score in the prediction of muscle-invasive bladder cancer were calculated.ResultsA total of 166 patients were involved,including 16(9.6%)patients with VI-RADS1,98(59.0%)with VI-RADS2,18(10.9%)with VI-RADS3,14(8.4%)with VI-RADS4 and 20(12.1%)with VI-RADS5.The AUC,sensitivity,specificity and accuracy was 0.886(0.825-0.947),80.4%(66.5%-89.7%),90.4%(83.2%-94.9%)and 87.3%(84.8%-89.9%),respectively.Logistic regression analysis indicated that VI-RADS score≥3 was an independent risk factor of muscle-invasive bladder cancer.ConclusionThe VI-RADS scoring system performs well in predicting the muscle-invasive condition of bladder cancer and can be recommended for routine preoperative assessment.