Ceylan Kadir, Taken Kerem, Gecit Ilhan, Pirincci Necip, Gunes Mustafa, Tanik Serhat, Karaman Ihsan
Department of Urology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
Asian Pac J Cancer Prev. 2010;11(4):1001-4.
To compare diffusion-weighted magnetic resonance imaging (DW-MRI) with cystoscopy in the diagnosis and follow-up of patients with bladder tumor and to investigate any histopathological correlation.
Totally 59 patients, between 31-85 years (mean age 60∓13) referred to our clinic due to a hematuria complaint were enrolled and evaluated by upper urinary system pathology and then DW-MRI (average 7 days) and cystoscopy. Apparent diffusion coefficients (ADCs) of images were calculated.
While a mass in bladder was determined with cystoscopy in 43 out of 59 patients,the mass was not determined in 16 of the patients (n=34 malign, n=9 benign). While a mass was determined in 40 out of 59 patients with DW-MRI,the mass was not determined in 19 of the patients(n=40 malign, n=19 benign). Regarding ADC values, mean ADC values of 34 patients who were diagnosed with a bladder tumor (1.05∓0.22x10(-3) mm2/s), were significantly lower than the mean ADC values obtained from the normal bladder wall (1.830∓0.18x10(-3) mm2/s) whereas a statistically significant difference was found (p<0.001). ADC values in 9 patients with a benign lesion (1.73∓0.12x10(-3) mm2/s), were not found statistically different from the mean ADC values obtained from the normal bladder wall (1.78∓0.2x10(-3) mm2/s) (p>0.05). A significant difference was determined between ADC values of benign lesions and the ADC values of malign lesions (p<0.001).
According to cystoscopy, values of DW-MRI's related with sensitivity, specificity and accuracy were found, respectively 90%, 93% and 91%. As the DW-MRI is a non-invasive and a rapid technique, and does not contain ionized radiation and because it is accepted as an important marker of tumor cellularity, it may be used as an alternative in future diagnosis and follow-up of bladder tumors.
比较扩散加权磁共振成像（DW-MRI）与膀胱镜检查在膀胱肿瘤患者诊断及随访中的应用，并探讨其与组织病理学的相关性。
共纳入59例因血尿主诉前来我院就诊的患者，年龄在31 - 85岁之间（平均年龄60±13岁），先进行上尿路系统病理学评估，然后进行DW-MRI（平均7天）及膀胱镜检查。计算图像的表观扩散系数（ADC）。
59例患者中，膀胱镜检查发现43例膀胱内有肿物，16例未发现肿物（恶性34例，良性9例）。DW-MRI检查发现59例患者中有40例膀胱内有肿物，19例未发现肿物（恶性40例，良性19例）。关于ADC值，34例诊断为膀胱肿瘤患者的平均ADC值（1.05±0.22×10⁻³mm²/s）显著低于正常膀胱壁的平均ADC值（1.830±0.18×10⁻³mm²/s），差异有统计学意义（p<0.001）。9例良性病变患者的ADC值（1.73±0.12×10⁻³mm²/s）与正常膀胱壁的平均ADC值（1.78±0.2×⁻³mm²/s）相比，差异无统计学意义（p>0.05）。良性病变与恶性病变的ADC值之间差异有统计学意义（p<0.001）。
根据膀胱镜检查结果，DW-MRI的敏感性、特异性和准确性分别为90%、93%和91%。由于DW-MRI是一种无创、快速的技术，不包含电离辐射，且被认为是肿瘤细胞密度的重要标志物，未来可作为膀胱肿瘤诊断及随访的替代方法。
