膀胱癌的CT及MRI临床诊断分析

Analysis of CT and MRI in Clinical Diagnosis of Bladder Cancer

目的探析CT及MRI检查在膀胱癌临床分期中的诊断价值。方法选取我院2012年6月-2014年6月经临床病理确诊的59例膀胱癌患者作为研究对象,均行CT与MRI诊断,对比CT和MRI诊断膀胱癌分期的准确率及影像学表现。结果以临床病理为"金标准",MRI诊断准确性、特异性分别为93.22%、94.29%显著高于CT的69.49%、65.71%(P<0.05)。CT上病灶呈菜花状、乳头状、丘地状,为等密度或稍高密度,部分可见钙化组织;增强扫描显示不同程度强化,延迟扫描以充盈缺损为主。MRI显示腔内型T1等信号,T2高信号,浸润型和腔外型T2上局部膀胱壁信号带连续性欠佳。17例增强扫描显示均存在不同程度的强化。结论 MRI诊断膀胱癌分期的准确性较高,对临床确定手术方案具有指导意义。

Objective To explore the diagnostic value of CT and MRI in the clinical staging of bladder cancer.Methods 59 cases of patients with bladder cancer confirmed by clinical pathology in our hospital from June 2012 to June 2014 were selected as the research object. All underwent CT and MRI diagnosis. The accuracy of CT and MRI in the diagnosis of bladder cancer staging and the imaging findings were compared.Results With clinical pathology as the golden standard, the diagnostic accuracy and specificity of MRI （93.22%, 94.29%） were significantly higher those of CT （69.49%, 65.71%） （P〈0.05）. CT showed that the lesions were cauliflower-like, papillary and dune-like, which showed equal or slightly high density, with partially visible calcification; The enhanced scan showed different degrees of enhancement and the delayed scan was mainly filling-defect. MRI showed intraluminal type equal signal on T1 and high signal on T2. For infiltrating type and exogastric type, the signal area in local bladder wall was with poor continuity on T2. The enhancement of 17 cases showed different degrees of enhancement.Conclusion The accuracy of MRI in diagnosis of bladder cancer staging is high, which is of guiding significance for the establishment of clinical surgical treatment.