摘要
目的:探讨3.0T磁共振成像(MRI)表观扩散系数(ADC)值和病灶面积在预测膀胱癌(BCa)肌层浸润性膀胱癌(MIBC)和非肌层浸润性膀胱癌(NMIBC)中的应用价值。方法:选取医院收治的经术后病理证实的35例(48个病灶)BCa患者,均行MRI平扫及弥散加权成像(DWI)序列扫描,将患者的48个病灶以病理结果为“金标准”分为MIBC组(21个)和NMIBC组(27个),测量MRI序列扫描中b值1000 s/mm^(2)时病灶的ADC值和病灶面积,分析ADC值、病灶面积与膀胱肿瘤浸润性的相关性和一致性;绘制受试者工作特征(ROC)曲线评价病灶ADC值和病灶面积在预测BCa的MIBC和NMIBC诊断效能。结果:MRI的ADC值、病灶面积在预测BCa的MIBC和NMIBC中与病理对照均有较好的一致性,NMIBC组的ADC值高于MIBC组,NMIBC组病灶面积小于MIBC组,其差异均有统计学意义(Z=-4.76,Z=-2.37;P<0.05);ADC值与BCa肌层浸润性呈负相关,与病灶面积则呈正相关(r=-0.722,r=0.383;P<0.01);ROC曲线显示预测BCa的MIBC和NMIBC中ADC值临界阈值为1.48×10^(-3)mm^(2)/s,ROC曲线下面积(AUC)为0.904,特异度和灵敏度分别85.7%和96.3%;病灶面积的临界阈值为441.5 mm^(2),AUC为0.701,特异度和灵敏度分别为92.6%和52.4%;ADC值对面积≥410.8 mm^(2)病灶的预测准确性更好。结论:MRI中ADC值是预测Bca患者MIBC和NMIBC的可靠指标,病灶面积可作为一种有效的辅助手段,均可为术前评估、治疗和手术方案制定提供临床依据。
Objective:To explore the application value of the apparent diffusion coefficient(ADC)value of 3.0T magnetic resonance imaging(MRI)and lesion area in predicting muscle-invasive bladder cancer(MIBC)and nonmuscle-invasive bladder cancer(NMIBC).Methods:35 bladder cancer(BCa)patients with 48 tumor lesions which were confirmed by pathology after surgery were selected as the research objects.Both MRI plain scan and DWI sequence scan were performed on them.The 48 lesions of patients were divided into MIBC group(21 lesions)and NMIBC group(27 lesions)according to pathological results which were used as gold standard.The ADC value and area of lesions as 1000 s/mm2 of b value in MRI sequence scan were measured,and the correlation and consistency among ADC value,lesion area and BCa invasion were analyzed.The curve of receiver operating characteristics(ROC)was drawn to evaluate the diagnostic efficiency of ADC value and area of lesion in predicting MIBC and NMIBC of BCa.Results:ADC value and lesion area of MRI were consistent with pathological results in predicting MIBC and NMIBC of bladder cancer,and the ADC value of NMIBC group was higher than that of MIBC,and the lesion area of NMIBC group was smaller than that of MIBC group,and the differences of them between two groups were statistically significant(Z=-4.76,Z=-2.37,P<0.05).The ADC value was significantly negative correlation with BCa muscle invasion,and lesion area was significantly positive correlation with that(r=-0.722,r=0.383,P<0.01).The ROC curve indicated that critical threshold value of ADC value was 1.48×10^(-3)mm^(2)/s in predicting MIBC and NMIBC of bladder cancer.And the area under curve(AUC)of ROC curve was 0.904.The specificity and sensitivity were 85.7%and 96.3%,respectively.The critical threshold value of lesion area was 441.5 mm^(2),AUC of that was 0.701,and the specificity and sensitivity of that were 92.6%and 52.4%respectively.The accuracy of ADC value was better in predicting lesions which area was≥410.8 mm^(2).Conclusion:ADC value of MRI is a reliab
作者
夏迎洪
朱海旭
曲源
艾力亚尔·买合木提
刘洋
陈杰
周豪
XIA Ying-hong;ZHU Hai-xu;QU Yuan(Radiology Imaging Center,Xinjiang Uiger Municipal People’Hospital,Urumqi 830001,China.)
出处
《中国医学装备》
2022年第4期60-64,共5页
China Medical Equipment
基金
新疆维吾尔自治区自然科学基金(2017D01C119)“基于多参数MR成像的膀胱肿瘤分期研究”。
