Hechler V, Rink M, Beyersdorff D, Beer M, Beer A J, Panebianco V, Pecoraro M, Bolenz C, Salomon G
Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Klinik und Poliklinik für Urologie, Universitätsklinikum Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Urologe A. 2019 Dec;58(12):1443-1450. doi: 10.1007/s00120-019-01061-3.
Initial clinical and pathological diagnostic workup of urinary bladder cancer is based on cystoscopy, transurethral resection of suspicious lesions, and computed tomography when indicated. Accurate staging is necessary for further therapeutic decision-making. This review summarizes the current status of multiparametric magnetic resonance imaging (mpMRI) and the vesical imaging-reporting and data system (VI-RADS) classification. MpMRI may improve the accuracy of assessment of local tumor invasion compared to conventional imaging alone. VI-RADS standardizes reporting of MRI staging and classifies the likelihood of muscle-invasive bladder cancer into five categories. Preliminary data suggest low interobserver variability. However, prospective multicenter studies are necessary to validate the VI-RADS classification. Progress in functional, molecular, and hybrid imaging may further improve the accuracy of clinical tumor and nodal staging for bladder cancer.
膀胱癌的初始临床和病理诊断检查基于膀胱镜检查、对可疑病变进行经尿道切除术以及必要时的计算机断层扫描。准确分期对于进一步的治疗决策至关重要。本综述总结了多参数磁共振成像（mpMRI）和膀胱影像报告与数据系统（VI-RADS）分类的现状。与单纯传统成像相比，mpMRI可能提高对局部肿瘤浸润评估的准确性。VI-RADS规范了MRI分期报告，并将肌层浸润性膀胱癌的可能性分为五类。初步数据表明观察者间变异性较低。然而，需要进行前瞻性多中心研究来验证VI-RADS分类。功能成像、分子成像和混合成像的进展可能进一步提高膀胱癌临床肿瘤和淋巴结分期的准确性。
