Multimodal magnetic resonance was used to determine the value of muscular invasion in bladder cancer
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摘要:
目的 探讨基于多模态磁共振成像上T2WI联合DWI+T2 SPAIR序列在判断膀胱癌肌层浸润价值与病理诊断结果的一致性。 方法 收集2020年3月~2022年3月因患有膀胱肿瘤在我院行磁共振检查并取得病理结果的患者60例,均行T2WI联合DWI序列、T2WI联合T2 SPAIR、DWI序列联合T2 SPAIR及T2WI联合DWI+T2 SPAIR序列检测。计算不同组合序列的检测结果对膀胱癌肌层是否受侵分期的检查效果及一致性评估。 结果 T2WI联合DWI+T2 SPAIR序列对肌层有无浸润的特异性、敏感度与准确度分别为95.46%(21/22)、89.47%(34/38)、91.67%(55/60),明显高于T2WI联合DWI序列、T2WI联合T2 SPAIR及DWI序列联合T2 SPAIR,差异有统计学意义(P < 0.05);T2WI联合DWI+T2 SPAIR序列与病理诊断结果的一致性最高。 结论 T2WI联合DWI+T2 SPAIR序列扫描方案可明显提高对膀胱癌T分期的诊断准确率,且T2WI联合DWI+T2 SPAIR序列与病理诊断结果的一致性最高,更有利于评估病灶肌层浸润情况。 Abstract:Objective To evaluate the value of T2 SPAIR sequence combined with T2WI + DWI in determining muscle layer invasion of bladder cancer based on multimodal MRI (mpMRI). Methods Sixty patients with bladder tumor who underwent magnetic resonance examination and obtained pathological results in our hospital from March 2020 to March 2022 were collected. T2WI combined with DWI sequence, T2WI combined with T2 SPAIR, DWI combined with T2 SPAIR and T2WI combined with DWI + T2 SPAIR sequence were detected. The results of different combination sequences were calculated to evaluate the efficacy and consistency of muscularis invasion stage of bladder cancer. Results The specificity, sensitivity and accuracy of T2WI combined with DWI+T2 SPAIR sequences for muscle layer infiltration were significantly higher than T2WI combined with DWI, T2WI combined with T2 SPAIR and DWI combined with T2 SPAIR(P < 0.05). SPAIR sequence of T2WI combined with DWI+T2 had the highest consistency with pathological diagnosis. Conclusion T2 SPAIR combined with DWI+ T2 SPAIR sequence scanning can significantly improve the diagnostic accuracy of T stage of bladder cancer, and T2WI combined with DWI+T2 SPAIR sequence has the highest consistency with pathological diagnosis, which is more conducive to the evaluation of muscle layer infiltration of lesions. -
Key words:
- bladder cancer /
- magnetic resonance imaging /
- muscular infiltration /
- case-control
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表 1 不同MRI序列组合方式检测结果与病理结果的比较情况
Table 1. Comparison of detection results and pathological results of four different MRI sequence combinations (n=60)
病理结果 T2WI联合DWI序列 T2WI联合T2SPAIR DWI序列联合T2SPAIR T2WI联合DWI+T2SPAIR 肌层浸润 无肌层浸润 肌层浸润 无肌层浸润 肌层浸润 无肌层浸润 肌层浸润 无肌层浸润 肌层浸润(n=38) 26 12 25 13 27 11 34 4 无肌层浸润(n=22) 7 15 6 16 6 16 1 21 合计(n=60) 33 27 31 29 33 27 35 25 表 2 不同MRI序列组合方式的特异性、敏感度与准确性及与病理诊断结果的一致性
Table 2. Comparison of specificity, sensitivity and accuracy of four different MRI sequence combinations and consistency with pathological diagnosis results
检查序列 特异性(%) 敏感度(%) 准确度(%) Kappa值 一致性 T2WI联合DWI序列 68.18(15/22) 68.42(26/38) 68.33(41/60) 0.349 差 T2WI联合T2 SPAIR 72.73(16/22) 65.79(25/38) 68.33(41/60) 0.369 差 DWI序列联合T2 SPAIR 72.73(16/22) 71.05(27/38) 86.00(43/60) 0.418 一般 T2WI联合DWI+T2 SPAIR序列 95.46(21/22) 89.47(34/38) 91.67(55/60) 0.826 高 X2 5.500 5.067 10.208 P 0.019 0.024 0.001 X12 4.247 6.138 10.208 P1 0.039 0.013 0.001 X22 4.247 4.070 8.015 P2 0.039 0.044 0.005 χ2、P为T2WI联合DWI序列与T2WI联合DWI+T2 SPAIR比较;χ12、P1为T2WI联合T2 SPAIR与T2WI联合DWI+T2 SPAIR比较;χ22、P2为DWI序列联合T2 SPAIR与T2WI联合DWI+T2 SPAIR序列扫描比较. -
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