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表观扩散系数比值在膀胱癌术前分级诊断中的应用

[Application of apparent diffusion coefficient ratio in the diagnosis of bladder cancer grading pre-operation].

作者信息

Zhou Guo-xing, Wang Yi-bin, Hao Nan-xin, Wu Ying-wei, Zhu Jing-qi, Wang Bo, Wang Zhong-qiu, Tao Xiao-feng

机构信息

Department of Radiology, Affiliated Oriental Hospital, Tongji University, Shanghai 200120 China.

Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2013 Oct 8;93(37):2953-6.

PMID:24401582
Abstract

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/mm(2)).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 muscle-invasive 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 pre-operation.

摘要

目的

通过分析不同分级膀胱癌的表观扩散系数(ADC)比值差异,探讨其在膀胱癌术前诊断中的价值。

方法

52例膀胱癌患者均经组织学确诊。术前对每位患者进行磁共振成像(MRI)及扩散加权成像(DWI)常规检查。在工作站构建ADC图,测量肿瘤及闭孔内肌的ADC值(b = 800 s/mm(2))。以闭孔内肌为参照部位计算ADC比值。然后分析ADC比值与膀胱癌分级的关系。

结果

所有肿瘤的平均ADC比值为0.98±0.35,G1级为(1.12±0.21),G2级为(0.67±0.29),ADC比值的敏感度和特异度分别为90.2%和85.3%,最佳阈值为0.96。低级别组的ADC比值显著高于高级别组,非肌层浸润组的值显著高于肌层浸润组。肿瘤的ADC比值与膀胱癌的恶性程度呈负相关(r = -0.845,P < 0.05)。

结论

膀胱癌的ADC比值反映了病变组织特性。其测量在膀胱癌术前分级诊断中起重要作用。

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