基于膀胱影像报告和数据系统（VI-RADS）的多参数 MRI 鉴别肌层浸润性和非肌层浸润性膀胱癌。
Multiparametric MRI in differentiation between muscle invasive and non-muscle invasive urinary bladder cancer with vesical imaging reporting and data system (VI-RADS) application.
机构信息
Lecturer of radio diagnosis, Radio diagnosis department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Urology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
出版信息
Br J Radiol. 2019 Dec;92(1104):20190401. doi: 10.1259/bjr.20190401. Epub 2019 Oct 8.
OBJECTIVE
To evaluate role of multiparametric MRI (mp-MRI) in differentiation between invasive and non-invasive bladder cancer and accuracy of vesical imaging reporting and data system (VI-RADS) score.
METHODS AND MATERIALS
50 patients diagnosed as cancer bladder were enrolled in this study, mp-MRI including conventional ( weighted imaging and high resolution weighted imaging) and functional sequences (diffusion-weighted imaging and dynamic contrast enhanced-MRI) were done, all data were regrouped to evaluate the accuracy of each separate sequence and mp-MRI in distinguishing non-muscle invasive from muscle-invasive tumors, with VI-RADS score application and comparison with pathological findings, then interobserver agreement for detection of muscle invasion according to mp-MRI and VI-RADS scoring system findings was calculated.
RESULTS
Diagnostic accuracy of mp-MRI in differentiation between muscle invasive and non-muscle invasive bladder cancer was (84%) with highest sensitivity (78%), very good agreement between mp-MRI and histopathological data ( = 0.87), and highest area under curve (AUC) reaching 0.83, dynamic contrast enhanced-MRI sequence showed the highest accuracy in muscle invasion detection by (88%), with highest AUC 0.83. Diagnostic accuracy of VI-RADS score in detection of muscle invasion was 84%, with specificity and negative predictive value of 88% and AUC was 0.83. Interobserver agreement was strong as regard diagnostic performance of mp-MRI and VI-RADS scoring for detection of muscle invasion reaching ( = 0.82, < 0.001) and ( = 0.87, < 0.001) respectively.
CONCLUSION
mp-MRI is considered as comprehensive and effective tool for determination of muscle invasion in cases of urinary bladder cancer. Also VI-RADS scoring system can accurately differentiate between invasive and non-invasive bladder cancer.
ADVANCES IN KNOWLEDGE
The VI-RADS system was recently suggested for the uniform evaluation of muscle invasion in cancer bladder by mp-MRI. In this paper, we applied this system to 50 cases to evaluate its ease and compared the results with the histopathological findings for evaluation of its accuracy.
目的
评估多参数 MRI（mp-MRI）在鉴别浸润性和非浸润性膀胱癌中的作用，以及膀胱影像报告和数据系统（VI-RADS）评分的准确性。
方法和材料
本研究纳入了 50 例被诊断为膀胱癌的患者，进行了 mp-MRI 检查，包括常规（加权成像和高分辨率加权成像）和功能序列（扩散加权成像和动态对比增强 MRI）。所有数据均进行分组，以评估每个单独序列和 mp-MRI 在鉴别非肌层浸润性和肌层浸润性肿瘤方面的准确性，同时应用 VI-RADS 评分并与病理结果进行比较，然后计算 mp-MRI 和 VI-RADS 评分系统对肌层浸润检测的观察者间一致性。
结果
mp-MRI 鉴别肌层浸润性和非肌层浸润性膀胱癌的诊断准确性为（84%），敏感性最高（78%），mp-MRI 与组织病理学数据之间具有很好的一致性（ = 0.87），曲线下面积（AUC）最高可达 0.83。动态对比增强 MRI 序列在肌层浸润检测中的准确性最高（88%），AUC 最高为 0.83。VI-RADS 评分检测肌层浸润的诊断准确性为 84%，特异性和阴性预测值分别为 88%和 AUC 为 0.83。mp-MRI 和 VI-RADS 评分系统对肌层浸润检测的诊断性能具有很强的观察者间一致性，分别为（ = 0.82，<0.001）和（ = 0.87，<0.001）。
结论
mp-MRI 被认为是确定膀胱癌肌层浸润的综合有效工具。此外，VI-RADS 评分系统可以准确地区分浸润性和非浸润性膀胱癌。
知识进展
最近，VI-RADS 系统被提议用于 mp-MRI 对膀胱癌肌层浸润的统一评估。在本文中，我们将该系统应用于 50 例病例，以评估其易用性，并将结果与组织病理学发现进行比较，以评估其准确性。
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