Ohgiya Yoshimitsu, Suyama Jumpei, Sai Shoei, Kawahara Masaaki, Takeyama Nobuyuki, Ohike Nobuyuki, Sasamori Hiroto, Munechika Jiro, Saiki Makoto, Onoda Yui, Hirose Masanori, Gokan Takehiko
Department of Radiology, Showa University School of Medicine.
Magn Reson Med Sci. 2014;13(3):175-81. doi: 10.2463/mrms.2013-0104. Epub 2014 Jul 2.
We evaluated the ability of diffusion-weighted imaging (DWI) at 3 tesla for diagnosing T stage and detecting stalks in bladder cancer.
In total, 39 consecutive patients with bladder tumors underwent magnetic resonance (MR) imaging that included T2-weighted imaging (T2WI) and DWI using a 3T MR scanner. Two radiologists interpreted T2WI plus DWI and T2WI for diagnosis of T stage and for detection of stalks. We used McNemar's test to examine differences in diagnostic performance and Fisher's exact test to evaluate differences in stalk detection frequency.
Specificity and accuracy in differentiating T1 tumors from T2 to T4 tumors were significantly better with T2WI plus DWI (83% [20/24] and 85% [33/39]) than T2WI (50% [12/24] and 67% [26/39]; P = 0.02), and accuracy for diagnosing tumor stage was significantly better with T2WI plus DWI (82% [32/39]) than T2WI alone (59% [23/39]; P = 0.03). The observers identified stalks in 11 tumors by T2WI (48% [11/23]) and 17 by DWI (74% [17/23]) (P < 0.03).
DWI at 3T was superior to T2WI for evaluating the T stage of bladder cancer, particularly in differentiating T1 tumors from those T2 or higher, and in detecting stalks of papillary bladder tumors.
我们评估了3特斯拉扩散加权成像（DWI）诊断膀胱癌T分期及检测蒂部的能力。
总共39例连续的膀胱肿瘤患者接受了磁共振（MR）成像，包括使用3T MR扫描仪进行的T2加权成像（T2WI）和DWI。两名放射科医生解读T2WI加DWI以及T2WI，以诊断T分期并检测蒂部。我们使用McNemar检验来检查诊断性能的差异，并使用Fisher精确检验来评估蒂部检测频率的差异。
T2WI加DWI在区分T1肿瘤与T2至T4肿瘤时的特异性和准确性（分别为83% [20/24]和85% [33/39]）显著优于T2WI（分别为50% [12/24]和67% [26/39]；P = 0.02），并且T2WI加DWI诊断肿瘤分期的准确性（82% [32/39]）显著优于单独的T2WI（59% [23/39]；P = 0.03）。观察者通过T2WI在11个肿瘤中识别出蒂部（48% [11/23]），通过DWI在17个肿瘤中识别出蒂部（74% [17/23]）（P < 0.03）。
3T的DWI在评估膀胱癌T分期方面优于T2WI，特别是在区分T1肿瘤与T2或更高分期肿瘤以及检测乳头状膀胱肿瘤的蒂部方面。
