| 程 丽,汪秀玲,徐 凯,李江山,宋 强.多参数MRI对腺性膀胱炎与膀胱癌的鉴别及膀胱癌病理分期的诊断价值分析[J].,2023,(24):4730-4735 |
| 多参数MRI对腺性膀胱炎与膀胱癌的鉴别及膀胱癌病理分期的诊断价值分析 |
| The Value of Multi-parameter MRI in the Differential Diagnosis of Glandular Cystitis and Bladder Cancer and the Diagnostic Value of Pathological Staging of Bladder Cancer |
| 投稿时间：2023-06-05 修订日期：2023-06-30 |
| DOI：10.13241/j.cnki.pmb.2023.24.026 |
| 中文关键词: 多参数 MRI 腺性膀胱炎 膀胱癌 鉴别诊断 病理分期 |
| 英文关键词: Multiple parameters MRI Cystitis glandularis Bladder cancer Differential diagnosis Pathological staging |
| 基金项目:江苏省社会发展项目(BE20191505) |
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| 中文摘要: |
| 摘要 目的：分析多参数磁共振成像（MRI）对腺性膀胱炎与膀胱癌的鉴别及膀胱癌病理分期的诊断价值。方法：选取2019年2月～2023年2月本院收治50例腺性膀胱炎和50例膀胱癌患者进行研究，均采用MRI多参数[高分辨率T2加权图像（HR T2WI）、弥散加权成像（DWI）、动态强磁共振成像（DCE-MRI）]检查，分析腺性膀胱炎与膀胱癌的HR T2WI、DWI、DCE-MRI信号强度；以病理检查结果为诊断金标准，分析MRI参数单一诊断和联合诊断膀胱癌的正确病理分期检出率，并采用Kappa系数分析MRI多参数单一和联合诊断膀胱癌病理结果的一致性，同时计算MRI参数联合诊断在膀胱癌病理分期的诊断效能。结果：与腺性膀胱炎比较，膀胱癌HR T2WI、DWI、DCE-MRI高强度占比较高（P＜0.05）。与HR T2WI、DCE-MRI比较，T2WI+DWI+DCE-MRI正确分期诊断率较高（P＜0.05）。T2WI+DWI+DCE-MRI诊断膀胱癌分期与病理结果一致性很强，Kappa值＞0.80。HR T2WI+DWI+DCE-MRI对膀胱癌T1分期诊断的灵敏度、特异度、阳性预测值、阴性预测值、诊断准确率分别为93.75%、94.44%、96.77%、89.47%、94.00%；T2分期分别为91.67%、94.74%、84.62%、97.30%、94.00%，T3分期分别为100.00%、93.48%、57.14%、100.00%、94.00%，T4分期分别为100.00%、93.75%、40.00%、100.00%、94.00%，≤T1 vs ≥T2分别为94.44%、93.75%、89.47%、96.77%、94.00，≤T2 vs ≥T3分别为100.00%、93.18%、66.67%、100.00%、94.00%。结论：MRI多参数信号强度可有效鉴别诊断腺性膀胱炎和膀胱癌，且多参数联合诊断可提升病理分期的诊断效能。 |
| 英文摘要: |
| ABSTRACT Objective: The diagnostic value of multi-parameter magnetic resonance imaging ( MRI ) in the differential diagnosis of cystitis glandularis and bladder cancer and the pathological staging of bladder cancer was analyzed. Methods: Fifty cases of glandular cystitis and 50 cases of bladder cancer admitted to our hospital from February 2019 to February 2023 were studied, all of which were examined by MRI multi-parameter [high-resolution T2-weighted images (HR T2WI), diffusion-weighted imaging (DWI), dynamic strong magnetic resonance imaging (DCE-MRI)]. The intensity of HR T2WI, DWI and DCE-MRI signals in glandular cystitis and bladder cancer were analyzed. Taking pathological examination results as the diagnostic gold standard, the detection rate of correct pathological staging of single MRI parameter diagnosis and combined diagnosis of bladder cancer was analyzed, and Kappa coefficient was used to analyze the consistency of pathological results of single MRI parameter diagnosis and combined diagnosis of bladder cancer, and the diagnostic efficacy of combined MRI parameter diagnosis in the pathological staging of bladder cancer was calculated. Results: Compared with glandular cystitis, high intensity of HR T2WI, DWI and DCE-MRI in bladder cancer was higher (P<0.05). Compared with HR T2WI and DCE-MRI, the correct stage diagnosis rate of T2WI+DWI+DCE-MRI was higher(P<0.05). T2WI + DWI + DCE-MRI diagnosis of bladder cancer staging and pathological results are highly consistent, Kappa value > 0.80. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of HR T2WI+DWI+DCE-MRI for the staging of bladder cancer T1 were 93.75%, 94.44%, 96.77%, 89.47%, 94.00%, respectively. The T2 staging was 91.67%, 94.74%, 84.62%, 97.30%, 94.00%, and the T3 staging was 100.00%, 93.48%, 57.14%, 100.00%, 94.00%, respectively. T4 stages were 100.00%, 93.75%, 40.00%, 100.00%, 94.00%, ≤T1 vs ≥T2 94.44%, 93.75%, 89.47%, 96.77%, 94.00, respectively. ≤T2 vs ≥T3 were 100.00%, 93.18%, 66.67%, 100.00% and 94.00%, respectively. Conclusion: MRI multi-parameter signal intensity can effectively identify cystitis glandularis and bladder cancer, and multi-parameter combined diagnosis can improve the diagnostic efficiency of pathological staging. |
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