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中华腔镜泌尿外科杂志(电子版) ›› 2017, Vol. 11 ›› Issue (06) : 404 -406. doi: 10.3877/cma.j.issn.1674-3253.2017.06.011

所属专题： 文献；

临床研究

MR扩散加权成像对膀胱尿路上皮癌的诊断价值
孟占鳌1, 何娅娣2, 夏桃林3, 罗子寰4, 陈晓波4, 高新4, 李辽源4,†()   
  1. 1. 510630　广州，中山大学附属第三医院放射科
    2. 510630　广州，中山大学附属第三医院体检中心
    3. 528000　佛山市第一人民医院泌尿外科
    4. 510630　广州，中山大学附属第三医院泌尿外科
  • 收稿日期:2017-08-15 出版日期:2017-12-01
  • 通信作者: 李辽源
  • 基金资助:
    国家自然科学基金项目(81502206); 广东省自然科学基金项目(2014A030313088)

The role of diffusion-weighted MR imaging in the diagnosis of bladder urothelial cancer

Zhanao Meng1, Yadi He2, Taolin Xia3, Zihuan Luo4, Xiaobo Chen4, Xin Gao4, Liaoyuan Li4,†()   

  1. 1. Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
    2. Department of Physical Examination, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
    3. Department of Urology, the First People's Hospital of Foshan City, Guangdong 528000, China
    4. Department of Urology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China
  • Received:2017-08-15 Published:2017-12-01
  • Corresponding author: Liaoyuan Li
  • About author:
    Corresponding author: Li Liaoyuan, Email:
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引用本文：

孟占鳌, 何娅娣, 夏桃林, 罗子寰, 陈晓波, 高新, 李辽源. MR扩散加权成像对膀胱尿路上皮癌的诊断价值[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(06): 404-406.

Zhanao Meng, Yadi He, Taolin Xia, Zihuan Luo, Xiaobo Chen, Xin Gao, Liaoyuan Li. The role of diffusion-weighted MR imaging in the diagnosis of bladder urothelial cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(06): 404-406.

目的

探索MR扩散加权成像（DWI）对膀胱尿路上皮癌的诊断价值。

方法

从2015年6月至2016年12月，将我院已进行MR扩散加权成像检查共72例膀胱疾病患者，根据病理结果分为膀胱良性疾病组（n=23）和膀胱尿路上皮癌组（n=49）,比较膀胱良性疾病组和膀胱尿路上皮癌组术前的肿瘤平均表观扩散系数（ADC）值，采用受试运算特性（ROC）方法确定最佳诊断Cut-off值。

结果

膀胱良性疾病组和膀胱尿路上皮癌术前ADC值分别为（1.86±0.40）×10-3 mm2/s和（0.93±0.11）×10-3 mm2/s，差别具有统计学意义（P<0.01）；ADC值在肿瘤分级间的差别有统计学意义；ADC值诊断膀胱尿路上皮癌的ROC曲线下面积为0.705；ADC值诊断膀胱尿路上皮癌时兼顾敏感性和特异性的最佳Cut-off值为1.32×10-3 mm2/s，此Cut-off值的敏感性和特异性分别为87.2%和82.9%。

结论

MR扩散加权成像ADC值可作为一种早期诊断膀胱尿路上皮癌的客观指标。

关键词: 膀胱尿路上皮癌, 诊断, MR扩散加权成像
Objective

To evaluate the value of diffusion-weighted MR imaging in diagnosis of urothelial cancer.

Methods

From June 2015 to December 2016, 72 consecutive patients with suspicious bladder lesions were accessed in our hospital. According to the results of pathological examination, the patients were divided into two groups: benign lesions group (n=23) and urothelial cancer group (n=49). The apparent diffusion coefficient (ADC) values of all patients was analyzed. The receiver operating characteristic (ROC) curves were generated by plotting the sensitivity versus specificity. Area under the cures was calculated for ADC assay.

Results

There was significant difference in ADC values between benign lesions group and urothelial cancer group [(1.86±0.40)×10-3mm2/s vs (0.93±0.11) ×10-3mm2/s, P<0.01]. Area under the ROC curves of ADC values were 0.705. The specificity and sensitivity of ADC values were 82.9% and 87.2% respectively at the optimum cutoff value (1.32×10-3 ) mm2/s.

Conclusions

ADC value could provide an objective and reliable biomarker for the early diagnosis of bladder urothelial cancer.

Key words: Bladder urothelial cancer, Diagnosis, Diffusion-weighted MR imaging
表1 两组患者的一般情况比较（±s）
组别 例数 性别（例） 年龄（岁） ADC值（×10-3mm2/s）
男 女
膀胱良性疾病组 23 13 10 52±7 1.86±0.40
膀胱尿路上皮癌组 49 27 22 55±7 0.93±0.11
统计值 ? χ2=0.013 t=1.36 t=18.24
P值 ? 0.91 0.18 <0.01
表2 ADC值诊断膀胱尿路上皮癌的效能分析
Cut-off值（10-3 mm2/s） 敏感性（%） 特异性（%） 阳性预测值（%） 阴性预测值（%）
1.26 75.0 57.3 65.8 73.4
1.13 80.0 54.1 61.2 74.9
1.04 85.0 50.6 60.4 78.5
0.96 90.0 49.2 59.7 81.3
0.85 95.0 44.7 57.3 82.6
0.71 100.0 36.5 52.6 100.0
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