Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
J Magn Reson Imaging. 2018 Jul;48(1):259-265. doi: 10.1002/jmri.25924. Epub 2017 Dec 12.
The bladder wall may thicken resulting from chronic inflammation after initial treatment (transurethral resection [TUR] or neoadjuvant chemotherapy), which may mimic the feature of recurrent or residual bladder tumors (RBT). Therefore, it is critical to discriminate RBT from benign lesions after initial treatment.
To investigate whether diffusion kurtosis imaging (DKI) could discriminate RBT from post-therapy bladder inflammatory lesions.
Retrospective.
Fifty patients diagnosed with bladder cancer underwent TUR or received neoadjuvant chemotherapy.
FIELD STRENGTH/SEQUENCE: 3.0T MRI/conventional T -weighted imaging (T WI), T WI, and diffusion-weighted imaging (DWI) with nine b-values ranging from 0-2000 s/mm .
Mean diffusion coefficients (MD , MD , and MD ) and mean kurtosis values (MK , MK , and MK ) were obtained from three different measurement methods. The region of interest (ROI) was placed 1) to encompass the entire portion of the thickening bladder wall or to portions that were the most restricted, with a b-value of 2) 2000 s/mm or 3) 1000 s/mm .
The independent-samples t-test was used to compare the differences between RBT and the inflammatory group. Differences in DKI parameters were analyzed by comparing the areas under the receiver-operator characteristic curves (AUCs).
In patients with RBT, the MD (MD , MD , MD ) values were significantly lower and the MK (MK , MK , MK ) values were significantly higher than those in patients in the inflammatory lesions group (all P < 0.01). The AUC of MK (0.934) was significantly larger than those of MD , MK , and MK (0.793, P < 0.05; 0.694, P < 0.01; 0.719, P < 0.01, respectively).
MK obtained from DKI provided better performance than conventional DWI in distinguishing RBT from inflammatory lesions after bladder cancer treatment. MK calculated with high b-values setting provided better performance in differentiation.
1 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2017.
初始治疗（经尿道膀胱肿瘤切除术[TUR]或新辅助化疗）后，膀胱壁可能会因慢性炎症而增厚，这可能与复发性或残留膀胱肿瘤（RBT）的特征相似。因此，区分初始治疗后的 RBT 与良性病变至关重要。
探究扩散峰度成像（DKI）是否可区分 RBT 与治疗后膀胱炎症性病变。
回顾性研究。
50 例诊断为膀胱癌的患者接受了 TUR 或新辅助化疗。
磁场强度/序列：3.0T MRI/常规 T1 加权成像（T1WI）、T2WI 和扩散加权成像（DWI），9 个 b 值范围为 0-2000 s/mm2。
从 3 种不同的测量方法中获得平均扩散系数（MD、MD 和 MD）和平均峰度值（MK、MK 和 MK）。感兴趣区（ROI）分别置于 1）整个膀胱壁增厚部分或 2）b 值为 2000 s/mm2 的最受限部分，或 3）b 值为 1000 s/mm2 的最受限部分。
采用独立样本 t 检验比较 RBT 与炎症组之间的差异。通过比较受试者工作特征曲线下的面积（AUC）来分析 DKI 参数的差异。
RBT 患者的 MD（MD、MD、MD）值明显低于炎症组，MK（MK、MK、MK）值明显高于炎症组（均 P<0.01）。MK 的 AUC（0.934）明显大于 MD、MK 和 MK（0.793，P<0.05；0.694，P<0.01；0.719，P<0.01）。
在区分膀胱癌治疗后 RBT 与炎症性病变方面，DKI 获得的 MK 优于常规 DWI。采用高 b 值设定计算的 MK 具有更好的区分性能。
1 技术功效研究 3 级 J. 磁共振成像 2017 年。
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