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膀胱癌的影像学检查：标准应用与未来趋势

Imaging of Bladder Cancer: Standard Applications and Future Trends.

作者信息

Abouelkheir Rasha Taha, Abdelhamid Abdalla, Abou El-Ghar Mohamed, El-Diasty Tarek

机构信息

Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt.

出版信息

Medicina (Kaunas). 2021 Mar 1;57(3):220. doi: 10.3390/medicina57030220.

DOI:10.3390/medicina57030220
PMID:33804350
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8000909/
Abstract

The evolution in imaging has had an increasing role in the diagnosis, staging and follow up of bladder cancer. Conventional cystoscopy is crucial in the diagnosis of bladder cancer. However, a cystoscopic procedure cannot always depict carcinoma in situ (CIS) or differentiate benign from malignant tumors prior to biopsy. This review will discuss the standard application, novel imaging modalities and their additive role in patients with bladder cancer. Staging can be performed with CT, but distinguishing between T1 and T2 BCa (bladder cancer) cannot be assessed. MRI can distinguish muscle-invasive from non-muscle-invasive tumors with accurate local staging. Vesical Imaging-Reporting and Data System (VI-RADS) score is a new diagnostic modality used for the prediction of tumor aggressiveness and therapeutic response. Bone scintigraphy is recommended in patients with muscle-invasive BCa with suspected bony metastases. CT shows low sensitivity for nodal staging; however, PET (Positron Emission Tomography)/CT is superior and highly recommended for restaging and determining therapeutic effect. PET/MRI is a new imaging technique in bladder cancer imaging and its role is promising. Texture analysis has shown significant steps in discriminating low-grade from high-grade bladder cancer. Radiomics could be a reliable method for quantitative assessment of the muscle invasion of bladder cancer.

摘要

成像技术的发展在膀胱癌的诊断、分期及随访中发挥着越来越重要的作用。传统膀胱镜检查在膀胱癌诊断中至关重要。然而，膀胱镜检查在活检前并不总能显示原位癌（CIS）或区分良性与恶性肿瘤。本综述将讨论膀胱癌患者的标准应用、新型成像模式及其附加作用。CT可用于分期，但无法评估T1期和T2期膀胱癌（BCa）之间的差异。MRI能够准确进行局部分期，区分肌肉浸润性肿瘤和非肌肉浸润性肿瘤。膀胱影像报告和数据系统（VI-RADS）评分是一种用于预测肿瘤侵袭性和治疗反应的新诊断方法。对于疑似骨转移的肌肉浸润性BCa患者，建议进行骨闪烁显像。CT对淋巴结分期的敏感性较低；然而，PET（正电子发射断层显像）/CT更为优越，强烈推荐用于再分期和确定治疗效果。PET/MRI是膀胱癌成像中的一种新成像技术，其作用前景广阔。纹理分析在区分低级别和高级别膀胱癌方面已取得显著进展。放射组学可能是定量评估膀胱癌肌肉浸润情况的可靠方法。

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