多参数磁共振成像在膀胱癌肌层浸润的诊断价值

Diagnostic value of multi-parametric magnetic resonance imaging in muscular infiltration of bladder cancer

目的探讨多参数磁共振成像在膀胱癌肌层浸润的诊断价值。方法选取2020年7月至2022年8月牡丹江医学院附属红旗医院收治的60例膀胱癌患者为研究对象,所有患者均进行T2加权成像(T2 weighted imaging,T2WI)、弥散加权成像(diffusion weighted imaging,DWI)、频率衰减反转恢复序列(T2 spectral attenuated inversion recovery,T2 SPAIR)及动态增强扫描(dynamic contrast enhanced scan,DCE)。比较DCE联合DWI+T2WI与T2 SPAIR联合DWI+T2WI两种不同序列组合的图像诊断与病理诊断结果的一致性。结果病理诊断结果显示肌层浸润35例(58.33%),无肌层浸润25例(41.67%)。将两种序列组合诊断结果与病理诊断结果对照,DCE联合DWI+T2WI序列诊断结果的一致性更高。DCE联合DWI+T2WI序列对诊断肌层有无浸润的敏感度和准确度均高于T2 SPAIR联合DWI+T2WI序列(P<0.05)。两种序列组合诊断肌层有无浸润的特异性比较差异无统计学意义(P>0.05)。结论T2 SPAIR联合DWI+T2WI评估膀胱癌是否存在肌层浸润的诊断效能尚可,对不能耐受DCE的患者不失为一种较好的选择。

Objective To investigate the diagnostic value of multi-parametric magnetic resonance imaging in muscular infiltration of bladder cancer.Methods Sixty patients with bladder cancer admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University from July 2020 to August 2022 were selected as the research objects,and all patients underwent T2 weighted imaging(T2WI),diffusion weighted imaging(DWI),T2 spectral attenuated inversion recovery(T2 SPAIR)and dynamic contrast enhanced scan(DCE).The consistency of image diagnosis and pathological diagnosis was compared between DCE combined with DWI+T2WI and T2 SPAIR combined with DWI+T2WI.Results Pathological diagnosis showed muscle infiltration in 35 cases(58.33%)and no muscle infiltration in 25 cases(41.67%).Comparing the results of the two sequences combination with the pathological diagnosis results,the diagnosis results of DCE combined with DWI+T2WI were more consistent.The sensitivity and accuracy of DCE combined with DWI+T2WI sequences were higher than that of T2 SPAIR combined with DWI+T2WI sequences in the diagnosis of muscular layer infiltration(P<0.05).There was no significant difference in the specificity between the two sequences in the diagnosis of muscle infiltration(P>0.05).Conclusion T2 SPAIR combined with DWI+T2WI has an acceptable diagnostic efficacy in evaluating the presence of muscular infiltration in bladder cancer,and it is a good choice for patients who cannot tolerate DCE.