两种膀胱准备方式在膀胱癌磁共振成像及术前鉴别肿瘤肌层浸润效能中的探索研究

Exploratory Research on the Influence of MR Image Quality of Bladder Cancer and Diagnostic Efficacy Using Two Preparation Methods

目的:探讨两种膀胱准备方法对膀胱癌磁共振成像(MRI)的图像质量及术前鉴别膀胱癌肌层浸润诊断效能的影响。方法:76例膀胱癌患者行术前磁共振检查,分为A组和B组,分别行两种不同的膀胱准备方式,对比两种方法在高分辨率T2WI上图像质量有无差别,并结合弥散加权成像(DWI)及动态增强成像(DCE)序列,判断两组病例磁共振图像对判断膀胱癌病灶肌层浸润情况的诊断效能有无影响。结果:两位阅片者之间一致性良好,A组(禁食4~6 h后于检查前排空膀胱并通过导尿管向膀胱内灌注约100 mL生理盐水后半小时内进行检查),与B组(检查前2 h排空膀胱内尿液后禁食禁水)相比,前者具有更优的膀胱充盈度评分;在诊断效能上,A组病例诊断肌层浸润性膀胱癌的敏感性及准确度均高于B组,但其差异无统计学意义。结论:检查前通过导尿管向膀胱内灌注适当容量(本研究为100 mL)生理盐水可作为一种辅助膀胱准备方法,帮助膀胱癌患者的膀胱适度充盈,以提高磁共振图像质量,进而提高膀胱磁共振诊断效能。

Purpose:To investigate the effects of two preparation methods on the image quality of bladder cancer magnetic resonance imaging(MRI)and the diagnostic performance of differentiation of muscular invasion of bladder cancer.Methods:76 cases of bladder cancer patients underwent preoperative MRI.They were divided into two groups and underwent two different bladder preparation methods respectively.The image quality of the two methods on high-resolution T2WI combined with diffusion-weighted imaging(DWI)and dynamic contrast-enhanced imaging(DCE)was compared.To determine whether the MR images of the two groups of patients have any influence on the diagnostic performance of the bladder cancer lesions in muscle invasion.Results:The consistency between the two readers was good.Compared with group B(urinate 2 hours prior to bladder MRI with no drinking),group A(after 4 to 6 hours of fasting,inject about 100 ml of physiological saline into the bladder before the examination through the catheter)had a better bladder filling degree.In terms of diagnostic efficiency,the sensitivity and accuracy of group A in diagnosing muscle-invasive bladder cancer were higher than those of group B,the difference has no statistically significant.Conclusion:Injecting an appropriate volume of physiological saline into the bladder before MR examination can be used as a clinical assistant bladder preparation method which help patients with bladder cancer properly fill the bladder,improve the quality of magnetic resonance images,and help improve the diagnosis of bladder cancer with magnetic resonance.