多层螺旋CT增强扫描与超声造影在膀胱癌术前分期中的诊断价值

目的研究多层螺旋CT(MSCT)增强扫描与超声造影(CEUS)在膀胱癌术前分期中的诊断价值。方法采用回顾性分析方法,以2018年6月至2020年6月北京中医医院顺义医院收治入院的102例膀胱癌患者为研究对象,所有患者均经手术病理确诊,并均选取多层螺旋CT(MSCT)增强扫描与超声造影(CEUS)进行术前分期检查,以术后病理诊断分期为金标准,比较膀胱癌术前分期诊断中MSCT与CEUS的准确率,并绘制受试者工作特征曲线(ROC),比较MSCT与CEUS对膀胱癌的诊断价值。结果膀胱癌术前分期诊断中,MSCT与CEUS的T1、T4期膀胱癌诊断符合率差异无统计学意义(P> 0.05);较CEUS,MSCT的T2期膀胱癌诊断符合率更低(75.00%vs. 95.83%),T3期膀胱癌诊断符合率更高(90.32%vs. 58.06%),差异均有统计学意义(P <0.05)。CEUS对T2期膀胱癌的诊断效能较好(AUC=0.700,95%CI:0.461~0.937),MSCT对T3期膀胱癌的诊断效能较好(AUC=0.750,95%CI:0.524~0.974)。结论MSCT与CEUS在膀胱癌术前分期诊断中各有优势,MSCT诊断T2期膀胱癌的符合率低于CEUS,但T3期膀胱癌诊断符合率更高,临床医师应根据实际情况选取最佳诊断方式。

Multislice spiral CT and contrast enhanced ultrasound in preoperative staging of bladder cancer

Objective To investigate the diagnostic value of enhanced multi-slice spiral CT( MSCT) and contrast enhanced ultrasound( CEUS) in preoperative staging of bladder cancer. Methods A total of 102 patients with bladder cancer admitted to Beijing Hospital of Traditional Chinese Medicine,Shunyi Hospital from June 2018 to June 2020 were retrospectively selected as the research object. All patients were confirmed by surgical pathology,and preoperative staging was performed on MSCT and CEUS. Postoperative pathological diagnosis staging was used as the gold standard. The accuracy of MSCT and CEUS in preoperative staging diagnosis of bladder cancer was compared,and the receiver operating characteristic curve( ROC) was plotted to compare the diagnostic value of MSCT and CEUS. Results There was no significant difference in the diagnostic coincidence rate between MSCT and CEUS for T1 and T4 bladder cancer( P > 0. 05). Compared with CEUS,MSCT had a lower diagnostic coincidence rate of T2 bladder cancer( 75. 00% vs. 95. 83%) and a higher diagnostic coincidence rate of T3 bladder cancer( 90. 32% vs.58. 06%),the differences were statistically significant( P < 0. 05). CEUS had a better performance in the diagnosis of T2 bladder cancer( AUC= 0. 700,95% CI : 0. 451-0. 937) and MSCT had a better performance in the diagnosis of T3 bladder cancer( AUC = 0. 750,95% CI : 0. 524-0. 974). Conclusion MSCT and CEUS have different advantages in preoperative staging diagnosis of bladder cancer. The coincidence rate of MSCT in diagnosing T2 bladder cancer is lower than that of CEUS,but the coincidence rate of T3 bladder cancer is higher. Clinicians should select the best diagnosis method according to the actual situation.