DWI结合LAVA技术对膀胱癌的诊断价值

Diagnostic Value of DWI Combined with Lava to Bladder Cancer

目的:探讨DWI及LAVA增强扫描对膀胱癌诊断及在术前分期中的应用价值。方法:搜集我院经手术病理证实的30例膀胱癌患者的常规MRI平扫、DWI及LAVA增强资料对其进行分析,总结出膀胱癌在DWI结合LAVA增强中的表现,判断其临床分期,并与术后病理分期结果进行比较。结果:膀胱三角区及膀胱后侧壁是膀胱癌最常见的好发部位,肿瘤平扫T1WI呈中等信号,T2WI呈中高信号,DWI呈明显高信号,其生长方式为:乳头状16例,广基底肿块型8例,沿膀胱壁浸润生长型6例。LAVA增强所有病例在动脉早期显著强化。MRI对病变检出敏感性为100%,DWI结合LAVA与临床病理分期符合率为93.3%(28/30),且均较病理分期偏高。结论:膀胱癌的DWI及LAVA增强表现具有特征性,在肿瘤术前诊断及分期尤其有明显优势。

Objective ：To deal with the effective value of DWI and LAVA on diagnosis and preoperative staging of bladder cancer. Methods： Data of routine plain MRI, DWI and LAVA enhancement from 30 patients with bladder cancer confirmed by operation and pathology were collected and analyzed; the performances of bladder cancer in DWI combined with LAVA enhancement were reviewed for judgment of the clinical stage, and compared with post- operative pathologic results. Results： The most common predilection sites of bladder cancer were in trigone and posterior wall of bladder, and tumors exhibited isointensity on T1WI, medium -hyper intensity on T2WI and obvi- ous hyper - intensity on DWI. The growth patterns are as follow ： 16 cases of papillary type, 8 cases of broad base mass type, 6 cases of infiltrating along the bladder wall type. All of the cases are significantly enhanced in the early arterial phase of LAVA enhancement. Detected sensitivity of lesions is 100% on MR! ; the according rate in DWI combined with LAVA and clinical staging of bladder cancer was 93.3 %, and diagnostic according rate of MRI stages are higher than that of pathological stages. Conclusions： DWI and LAVA performances are characteristic for bladder cancer and have obvious advantages in preoperative diagnosis and staging.