超声内镜联合MSCT检查对膀胱癌术前T分期诊断价值研究

Value of Endoscopic Ultrasonography Combined with Multi-slice Spiral CT(MSCT)in the Diagnosis of Preoperative T-stage of Bladder Cancer

目的旨在探讨超声内镜联合多层螺旋CT(MSCT)检查对膀胱癌术前T分期诊断价值。方法选取我院2017年2月至2018年2月收治的膀胱癌患者80例,80例患者均进行了超声内镜及MSCT检查,整理其临床资料、影像学资料等,以病理学检查结果为标准,对比单一超声内镜、MSCT检查及超声内镜联合MSCT检查对膀胱癌手术前T分期的诊断符合率。结果超声内镜对膀胱癌T分期的总诊断准确率为83.75%(67/80),MSCT对膀胱癌T分期的总诊断准确率为88.75%(71/80),超声内镜联合MSCT对膀胱癌T分期的总诊断准确率为98.75%(79/80),其中1例T2期病例被误诊为T3期,超声内镜联合MSCT对膀胱癌T分期的总诊断准确率明显高于单一超声内镜、MSCT检查,差异具有统计学意义(P<0.05);膀胱癌在超声内镜检查中主要表现类型为腔内型、腔外型、浸润型,肿瘤最小者5.12mm×8.12mm。腔内型主要为单发乳头状或菜花状改变,与膀胱壁软组织密度分界模糊。腔外型患者具备膀胱壁僵硬、不规则,肿块压向膀胱腔内。浸润型病灶外观不规则,向腔内凸出。46例患者表现为单纯乳头或菜花状肿块,多数患者出现膀胱壁增厚,边缘不整齐;12例患者出现钙化。在增强模式中,动脉期患者呈现明显均匀性或不均匀性强化,强化程度高于膀胱壁,静脉期、门脉期后强化程度逐渐下降。结论超声内镜联合MSCT检查诊断膀胱癌术前T分期准确性高,可为临床提高可靠影像学资料。

Objective To evaluate the value of endoscopic ultrasonography combined with multi-slice spiral CT(MSCT)in the diagnosis of preoperative T-stage of bladder cancer.Methods 80 patients with bladder cancer admitted to our hospital from February 2017 to February 2018 were selected.80 patients underwent endoscopic ultrasonography and MSCT examination,and their clinical data and imaging data were collected.The results of pathological examination were used as the standard to compare the diagnostic accuracy of single-endoscopic endoscopy,MSCT examination and endoscopic ultrasonography combined with MSCT examination for preoperative T-stage of bladder cancer.Results The total diagnostic accuracy of endoscopic ultrasonography for T-stage of bladder cancer was 83.75%(67/80).The total diagnostic accuracy of MSCT for T-stage of bladder cancer was 88.75%(71/80).The total diagnostic accuracy of endoscopic ultrasound combined with MSCT for bladder cancer for T-stage of bladder cancer was 98.75%(79/80).T2 stage of one case was misdiagnosed as T3 stage.The total diagnostic accuracy of endoscopic ultrasonography combined with MSCT for T stage of bladder cancer was significantly higher than that of single endoscopic ultrasonography and MSCT.The difference was statistically significant(P<0.05).The main types of bladder cancer in endoscopic ultrasonography were intraluminal type,extraluminal type,and invasive type,and the smallest tumor was 5.12 mm×8.12 mm.The intraluminal type was mainly single papillary change or cauliflower-like change,and the boundary with the soft tissue of the bladder wall was blurred.Patients with extraluminal type had stiff and irregular bladder wall and the mass was pressed into the bladder.The infiltrating lesion had an irregular appearance and protruded into the cavity.46 patients showed simple papillary or cauliflower-like masses.Most patients showed thickened bladder wall with irregular edges.In 12 patients,calcification occurred.In the enhanced mode,the patients in the arterial phase showed obvious homogeneous or heterogeneous enhancement,and the degree of enhancement was higher than that in the bladder wall.The degree of enhancement after the venous phase and the portal phase gradually decreased.Conclusion The accuracy of endoscopic ultrasonography combined with MSCT examination in the diagnosis of preoperative T-stage of bladder cancer is higher.It can provide reliable imaging data in clinic.