摘要
目的探讨基于膀胱影像报告与数据系统(VI-RADS)比较不同MRI序列组合诊断肌层浸润型膀胱癌(MIBC)的效能。方法搜集经手术病理确诊的112例(共127枚瘤灶)膀胱癌患者资料。所有患者均于3.0T MR行T2WI、DWI及DCE序列扫描,由此形成3种序列组合:T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE。根据VI-RADS评分标准分别对3种不同MRI序列组合进行评分。3种不同MRI序列组合VI-RADS评分在NMIBC与MIBC的差异性采用t检验进行比较。应用ROC曲线获得3种不同MRI序列组合诊断MIBC的曲线下面积(Az值),并计算相应的诊断敏感性、特异性、阳性预测值和阴性预测值。结果3种不同MRI序列组合VI-RADS评分在NMIBC与MIBC之间的差异均具有统计学意义(P值均<0.001)。以4分为最佳临界值,T2WI+DWI、T2WI+DCE、T2WI+DWI+DCE诊断MIBC的Az值分别为0.928、0.886、0.932,其中T2WI+DWI+DCE的Az值最大,T2WI+DCE最小。3种不同MRI序列组合中,T2WI+DWI+DCE诊断MIBC的敏感性和阴性预测值最高,T2WI+DWI诊断MIBC的特异性和阳性预测值最高。结论VI-RADS评分是一种较好的诊断MIBC的标准化、规范化方法。T2WI+DWI+DCE为诊断MIBC的最佳检查序列组合,T2WI+DWI可作为对比剂禁忌患者的优选方案。
Objective To evaluate the value of different MR sequence combination in the diagnosis of muscle invasive bladder cancer(MIBC)based on vesical imaging-reporting and data system(VI-RADS).Methods MRI data of 112 patients(127 tumors)with pathologically confirmed bladder cancer were retrospectively analyzed.3.0T MRI sequences were divided into three sequence combinations:T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE.The three MRI sequence combinations were scored according to VI-RADS.The VI-RADS scores for the three MRI sequence combinations were compared using the t-test between NMIBC and MIBC.The area under the curve(Az)of the three MRI sequence combinations in diagnosing MIBC were assessed by using receiver-operating characteristic curves(ROC),and the corresponding sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were calculated.Results The differences of VI-RADS scores for the three MRI sequence combinations between NMIBC and MIBC were statistically significant(P<0.001).With a cutoff value of score 4,the Az value of T2WI+DWI,T2WI+DCE,T2WI+DWI+DCE for diagnosing MIBC were 0.928,0.886 and 0.932,respectively.Among the three MRI sequence combinations,T2WI+DWI+DCE had the highest sensitivity and NPV for the diagnosis of MIBC,and T2WI+DWI had the highest specificity and PPV for the diagnosis of MIBC.Conclusion The VI-RADS has good diagnostic power as a standardized method for evaluation of MIBC.T2WI+DWI+DCE is the best combination for the diagnosis of MIBC,and T2WI+DWI can be used as an alternative in patients with contraindications to contrast-use.
作者
张添辉
程凤燕
罗润标
朱文标
杨日辉
范伟雄
ZHANG Tianhui;CHENG Fengyan;LUO Runbiao(Department of MRI,the People’s Hospital of Meizhou,Meizhou,Guangdong Province 514031,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第4期725-729,共5页
Journal of Clinical Radiology
关键词
磁共振成像
膀胱癌
膀胱影像报告与数据系统
Bladder cancer
Magnetic resonance imaging
Vesical imaging-reporting and data system
