磁共振弥散加权成像在诊断膀胱肿瘤恶性程度中的价值

目的:探讨磁共振弥散加权成像(diffusion weighted imaging,DWI)对膀胱肿瘤的诊断价值。方法:对36例膀胱肿瘤患者进行常规膀胱磁共振平扫检查及DWI检查,选取病灶感兴趣区测出膀胱肿瘤病灶区域大小,拟合出表观扩散系数(ADC)图,并在ADC图上直接测量不同b值(b=1 200、1 500s/mm2)及其膀胱肿瘤病灶的平均ADC值,进行量化分析。随后患者在1周内行经尿道膀胱肿瘤电切术,部分患者行根治性膀胱切除术,术中切除组织送病理检查。结果:36例患者中,b值为1 500、1 200s/mm2。在同一b值下,膀胱恶性肿瘤组的平均ADC值低于良性肿瘤组,分别为748.12±93.60、1 190.88±86.47,803.40±103.91、1 266.93±89.15(P0.05);膀胱高级别乳头状尿路上皮癌组的平均ADC值明显低于低级别乳头状尿路上皮癌组,分别为651.15±24.82、817.39±51.71,699.54±24.13、877.57±24.13(P0.05)。结论:DWI及ADC值在诊断膀胱肿瘤恶性程度中具有一定的价值。

Value of diffusion-weighted magnetic resonance imaging in the diagnosis of the degree of malignancy in bladder tumors

Objective：To discuss the value of diffusion-weighted magnetic resonance imaging in the diagnosis of bladder tumors. Method：Thirty-six patients with bladder tumors underwent conventional magnetic resonance imaging and diffusion weighted imaging. The focus regions of interest were selected and the size of the tumor and its apparent diffusion coefficient （ADC） value under different b value were measured （b= 1 200, 1 500 s/mmz ）. These patients underwent transurethral resection of bladder tumors, and some of which underwent radical cystec- tomy. Intraoperative tissue was sent to department of pathology to inspect. Result.. In 36 patients, b value was set at 1500 and 1200 s/mm2 respectively. Under the same b value, ADC value in the carcinoma group was significantly lower than that in the benign lesion group： 748.12 ±93.60, 1 190.88±86.47 and 803.40±103.91, 1 266.93 ±89.15 （P〈0.05）. Therewas a significant difference among the mean ADC value of different grades of malignant tumors, corresponding to 651.15±24.82, 817.39±51.71 and 699.54±24. 13, 877. 57±24. 13 in highgrade and lower-grade malignant bladder tumors （P〈0.05）. Conclusion.. Diffusion-weighted magnetic resonance imaging and ADC value may play a certain role in the diagnosis of the degree of malignancy in bladder tumors.