摘要
目的 通过分析表观弥散系数（ADC）比值在不同级别膀胱癌中的差别,探讨ADC比值在膀胱癌术前分级诊断中的价值.方法 收集2008年8月至2012年5月上海同济大学附属东方医院经手术病理证实的膀胱癌患者52例,患者术前行3.0T MRI检查及磁共振弥散加权成像（DWI）扫描.在工作站构建ADC图,以闭孔内肌作参比部位,分别测量肿瘤及闭孔内肌的ADC值（b =800s/mm2）,计算其ADC比值,分析ADC比值与膀胱癌病理分级的关系.结果 所有病灶的平均ADC比值为0.98±0.35,其中G1组为1.12 ±0.21,G2组为0.67±0.29,其诊断的敏感性和特异性分别为90.2％和85.3％,诊断临界值为0.96.低分级组的ADC比值显著高于高分级组,浅表型组的ADC比值显著高于浸润型组,病灶的ADC比值与肿瘤的恶性程度呈负相关关系（r=-0.845,P＜0.05）.结论 膀胱癌的ADC比值反映了病灶的组织特征,有助于膀胱癌术前评价,ADC比值的测量可作为膀胱癌术前分级诊断的指标之一,具有重要的临床指导意义.
Objective To explore the value of apparent diffusion coefficient （ADC） ratio in the diagnosis of bladder cancer pre-operation by analyzing its differences among different grades of bladder cancer.Methods A total of 52 cases of bladder cancer were all definitely diagnosed with histological results.Routine examinations of magnetic resonance imaging （MRI） and diffusion-weighted imaging （DWI） were performed preoperatively on each patient.ADC map was constructed in work station and ADC values of tumor and internal obturator muscle were measured （b =800 s/mm2）.Ratio of ADC was calculated with internal obturator muscle as reference site.Then the relationship between ADC ratio and bladder cancer grade was analyzed.Results Mean ratio of ADC of all tumors was 0.98 ± 0.35,G1 （1.12 ± 0.21） and G2 （0.67 ±0.29）,the sensitivity and specificity of ADC ratio was 90.2% and 85.3% respectively with an optimal threshold of 0.96.The ratios of ADC of low-grade group were significantly higher than those of high-grade group while the values of non-muscle-invasive group were significantly higher than those of muscleinvasive group.The ratios of ADC of tumor were inversely associated with the malignancy degree of bladder cancer （r =-0.845,P 〈 0.05）.Conclusion The ratio of ADC of bladder cancer reflects the lesion tissue properties.And its measurement plays an important role in the diagnosis of bladder cancer grading preoperation.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第37期2953-2956,共4页
National Medical Journal of China
基金
上海市卫生局科研基金资助课题（2009159）
关键词
表观弥散系数
膀胱肿瘤
磁共振弥散加权成像
Apparent diffusion coefficient
Bladder cancer
Diffusion weighted imaging
