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目的探讨MR扩散加权成像(DWI)对膀胱癌T分期的诊断价值。资料与方法使用Philips Achieva3.0 T高场强超导型MR机,应用腹部多通道相控阵线圈,对44例膀胱癌患者,共71处病灶行MR检查,观察其DWI表现,并与手术病理分期结果进行对照分析。结果 71处病灶中,有蒂型病灶占60.56%(43/71),在DWI上均表现为“C”形或“拱”形样结构,其T分期的诊断符合率为95.35%(41/43)。DWI诊断膀胱癌T分期的准确度非常高,其准确度、敏感度和特异度分别为88.73%、84%、91.3%。DWI对膀胱癌T分期准确性优于T2WI(71.83%),但联合T2WI,可提高其对分期诊断的准确性(90.14%)。结论 3.0 T高场强MR DWI所表现“C”形或“拱”形样结构,可作为早期膀胱癌较特征性的诊断征象。联合其他序列,可提高DWI对分期的诊断准确性。
Objective To investigate the diagnostic value of MR diffusion weighted imaging (DWI) in T staging of bladder cancer. Materials and Methods Using Philips Achieva3.0 T high-field-strength superconducting MR machine, abdominal multiple-phased phased-array coils were used in MR imaging of 44 patients with bladder cancer and 71 lesions. The DWI was observed and compared with surgery Pathological staging results were analyzed. Results Of the 71 lesions, 60.56% (43/71) had pedunculated lesions, and showed “C” or “arch” shape on DWI. The diagnostic accuracy of T stage was 95.35 % (41/43). The accuracy of DWI in diagnosing bladder cancer T staging is very high. The accuracy, sensitivity and specificity of DWI are 88.73%, 84% and 91.3% respectively. The accuracy of T stage in DWI was better than that in T2WI (71.83%), but combined with T2WI could improve the staging accuracy (90.14%). Conclusions The “C” or “arch” shape of 3.0 DWT MR DWI can be used as a more characteristic diagnostic sign of early stage bladder cancer. Combined with other sequences, can improve the diagnostic accuracy of DWI staging.