两种膀胱准备方式在膀胱癌磁共振成像及术前鉴别肿瘤肌层浸润效能中的探索研究

鄂天娇; 冯峰; 徐海飞

doi:10.15953/j.ctta.2022.209

两种膀胱准备方式在膀胱癌磁共振成像及术前鉴别肿瘤肌层浸润效能中的探索研究

doi: 10.15953/j.ctta.2022.209

鄂天娇^a,,
冯峰^a, ,,
徐海飞^b

1.
放射科；南通大学附属南通市肿瘤医院
2.
泌尿外科，江苏南通226001 南通大学附属南通市肿瘤医院

详细信息

作者简介:
鄂天娇：女，硕士，南通市肿瘤医院医师，主要从事肿瘤影像的CT、MRI诊断，E-mail：etianjiao0420@163.com

通讯作者:
南通市肿瘤医院主任医师，擅长胸部、腹部肿瘤的CT、MR及PET-CT的影像诊断，E-mail：drfengfeng@163.com

中图分类号: R 445；R 814
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出版历程
- 收稿日期: 2022-10-29
- 修回日期: 2023-02-17
- 录用日期: 2023-02-23
- 网络出版日期: 2023-06-12
- 刊出日期: 2023-07-31

Exploratory Research on the Influence of MR Image Quality of Bladder Cancer and Diagnostic Efficacy Using Two Preparation Methods

E Tianjiao^a
,,
FENG Feng^{a
, ,},
XU Haifei^b

1.
Nantong Tumor Hospital Afiiliated to Nantong University, Nantong 226001, China Radiology Department
2.
Nantong Tumor Hospital Afiiliated to Nantong University, Nantong 226001, China Urology Department

摘要

摘要: 目的：探讨两种膀胱准备方法对膀胱癌磁共振成像（MRI）的图像质量及术前鉴别膀胱癌肌层浸润诊断效能的影响。方法：76例膀胱癌患者行术前磁共振检查，分为A组和B组，分别行两种不同的膀胱准备方式，对比两种方法在高分辨率T2WI上图像质量有无差别，并结合弥散加权成像（DWI）及动态增强成像（DCE）序列，判断两组病例磁共振图像对判断膀胱癌病灶肌层浸润情况的诊断效能有无影响。结果：两位阅片者之间一致性良好，A组（禁食4～6 h后于检查前排空膀胱并通过导尿管向膀胱内灌注约100 mL生理盐水后半小时内进行检查），与B组（检查前2 h排空膀胱内尿液后禁食禁水）相比，前者具有更优的膀胱充盈度评分；在诊断效能上，A组病例诊断肌层浸润性膀胱癌的敏感性及准确度均高于B组，但其差异无统计学意义。结论：检查前通过导尿管向膀胱内灌注适当容量（本研究为100 mL）生理盐水可作为一种辅助膀胱准备方法，帮助膀胱癌患者的膀胱适度充盈，以提高磁共振图像质量，进而提高膀胱磁共振诊断效能。
- 磁共振成像 /
- 膀胱癌 /
- 诊断效能
Abstract: Purpose: To investigate the effects of two preparation methods on the image quality of bladder cancer magnetic resonance imaging (MRI) and the diagnostic performance of differentiation of muscular invasion of bladder cancer. Methods: 76 cases of bladder cancer patients underwent preoperative MRI. They were divided into two groups and underwent two different bladder preparation methods respectively. The image quality of the two methods on high-resolution T2WI combined with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced imaging (DCE) was compared. To determine whether the MR images of the two groups of patients have any influence on the diagnostic performance of the bladder cancer lesions in muscle invasion. Results: The consistency between the two readers was good. Compared with group B (urinate 2 hours prior to bladder MRI with no drinking), group A (after 4 to 6 hours of fasting, inject about 100 ml of physiological saline into the bladder before the examination through the catheter) had a better bladder filling degree. In terms of diagnostic efficiency, the sensitivity and accuracy of group A in diagnosing muscle-invasive bladder cancer were higher than those of group B, the difference has no statistically significant. Conclusion: Injecting an appropriate volume of physiological saline into the bladder before MR examination can be used as a clinical assistant bladder preparation method which help patients with bladder cancer properly fill the bladder, improve the quality of magnetic resonance images, and help improve the diagnosis of bladder cancer with magnetic resonance.
- magnetic resonance image /
- bladder neoplasms /
- diagnostic quality

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图 1 膀胱不同充盈度分类

Figure 1. The bladder distention degrees

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图 2 膀胱癌VI-RADS评分2分病例

Figure 2. The MR image of bladder cancer with VI-RADS score of 2

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图 3 膀胱癌VI-RADS评分5分病例

Figure 3. The MR image of bladder cancer with VI-RADS score of 5

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表 1 1.5T磁共振膀胱扫描序列参数表

Table 1. The scanning parameters of 1.5T MRI

扫描参数		TR/ms	TE/ms	FOV/mm	矩阵	层厚/层间距/mm	平均次数	采集时间/s	激发角度	b值/（s/mm²）
T2WI	Tra	6190	85	180	256×256	7.0/2.1	3	192	150	—
	Sag	6900	85	180	256×256	4.0/1.2	3	214	150
	Cor	6000	85	180	256×256	4.0/0.8	3	114	150
DWI		4400	100	400	—	6	6	120	—	0,1500
DCE		7.97	2.9	250	—	3	1	10	—

下载: 导出CSV

表 2 两组病例膀胱充盈情况

Table 2. Filling of bladder of two groups

组别	膀胱空虚/ 例（％）	膀胱部分充盈/ 例（％）	膀胱充盈良好/ 例（％）	膀胱充盈过饱/ 例（％）	膀胱内移动伪影/ 例（％）	合计/例
A组	0（0.0）	2（6.5）	26（83.9）	1（3.2）	2（2.5）	31
B组	3（6.7）	14（31.1）	21（46.7）	2（4.4）	5（11.1）	45
合计	3	16	47	3	7	76

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表 3 两组病例膀胱充盈度评分

Table 3. Bladder filling score of two groups

组别	1分/例（％）	2分/例（％）	3分/例（％）	合计/例
A组	2（6.5）	3（9.7）	26（83.9）	31
B组	8（17.8）	16（35.6）	21（46.7）	45
合计	10	19	57	76

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表 4 病例肌层浸润情况

Table 4. Diagnostic effectiveness of

病理结果	影像评估有无肌层浸润
病理结果	无（A组/B组）	有（A组/B组）	合计（A组/B组）/例
无	19/27	1/1	20/28
有	0/3	3/11	3/14
合计	19/30	4/12	23/42

下载: 导出CSV

参考文献(14)

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