Department of Radiology, Zhongshan Hospital, Shanghai Institute of Medical Imaging, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China.
Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, Xuhui District, 200032, People's Republic of China.
Eur J Radiol. 2021 Mar;136:109522. doi: 10.1016/j.ejrad.2021.109522. Epub 2021 Jan 6.
To prospectively compare the diagnostic efficacy of conventional diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC).
Multiple b value DWIs were performed using a 3-T magnetic resonance (MR) imaging unit in fifty-one patients with bladder cancer including MIBC and NMIBC confirmed by histopathological findings. DWI data were postprocessed using mono-exponential and DKI models to calculate the apparent diffusion coefficient (ADC), apparent diffusional kurtosis (K), and kurtosis-corrected diffusion coefficient (D). Receiver-operating characteristic (ROC) analysis was performed to compare the diagnostic efficacy of all diffusion parameters.
All parameters differed significantly between MIBC and NIMBC including increased K, decreased D and ADC (all p < 0.001). Only the combination of D and K was significantly higher than ADC (p < 0.05), whilst D and K were not statistically different from ADC.
Both conventional DWI and DKI models are beneficial in differentiating between MIBC and NMIBC, whilst the combination of D and K can produce a more robust value than conventional ADC value in evaluating aggressiveness of bladder cancer.
前瞻性比较常规弥散加权成像（DWI）和弥散峰度成像（DKI）在鉴别肌层浸润性膀胱癌（MIBC）和非肌层浸润性膀胱癌（NMIBC）中的诊断效能。
在 51 例膀胱癌患者中，使用 3T 磁共振（MR）成像仪进行了多 b 值 DWI 检查，这些患者均经组织病理学检查证实为 MIBC 和 NMIBC。使用单指数和 DKI 模型对 DWI 数据进行后处理，以计算表观扩散系数（ADC）、表观弥散峰度（K）和峰度校正的扩散系数（D）。进行受试者工作特征（ROC）分析以比较所有扩散参数的诊断效能。
所有参数在 MIBC 和 NIMBC 之间均有显著差异，包括 K 值增加、D 值和 ADC 值降低（均 p<0.001）。只有 D 和 K 的组合显著高于 ADC（p<0.05），而 D 和 K 与 ADC 无统计学差异。
常规 DWI 和 DKI 模型均有助于鉴别 MIBC 和 NMIBC，而 D 和 K 的组合在评估膀胱癌侵袭性方面可能比常规 ADC 值产生更稳健的价值。
