Pecoraro Martina, Cipollari Stefano, Messina Emanuele, Laschena Ludovica, Dehghanpour Ailin, Borrelli Antonella, Del Giudice Francesco, Muglia Valdair Francisco, Vargas Hebert Alberto, Panebianco Valeria
From the Department of Radiological Sciences, Oncology and Pathology (M.P., S.C., E.M., L.L., A.D., A.B., V.P.) and Department of Maternal-Infant and Urological Sciences (F.D.G.), Sapienza University/Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome, Italy; Department of Medical Images, Radiation Therapy and Oncohematology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil (V.F.M.); and Department of Radiology, NYU Langone Health, New York, NY (H.A.V.).
Radiology. 2025 Mar;314(3):e233459. doi: 10.1148/radiol.233459.
Multiparametric MRI of the bladder is highly accurate in the detection and local staging of bladder cancer. The Vesical Imaging Reporting and Data System (VI-RADS) scoring system has improved the diagnostic accuracy, reproducibility, and interpretability of bladder MRI in the assessment of the invasion of the muscularis propria. There are several technical details concerning bladder MRI that need to be strictly applied to obtain the highest possible diagnostic potential from the MRI. In addition, image evaluation, accurate interpretation, and reporting need to be standardized to optimize diagnostic accuracy and interreader agreement. This review describes the patient population for bladder MRI and discusses, with a practical approach, the correct acquisition protocol for optimal image quality using VI-RADS with reporting tips, pitfalls, and challenges for its clinical application. This review also discusses the latest evidence, clinical implications, current controversies, and future challenges, including gaps in knowledge, of the VI-RADS scoring system.
膀胱多参数磁共振成像在膀胱癌的检测和局部分期方面具有高度准确性。膀胱影像报告和数据系统（VI-RADS）评分系统提高了膀胱磁共振成像在评估固有肌层浸润方面的诊断准确性、可重复性和可解释性。关于膀胱磁共振成像有几个技术细节需要严格应用，以便从磁共振成像中获得尽可能高的诊断潜力。此外，图像评估、准确解读和报告需要标准化，以优化诊断准确性和阅片者之间的一致性。本综述描述了膀胱磁共振成像的患者群体，并以实用的方法讨论了使用VI-RADS获得最佳图像质量的正确采集方案，以及报告提示、陷阱和临床应用挑战。本综述还讨论了VI-RADS评分系统的最新证据、临床意义、当前争议和未来挑战，包括知识空白。
