| 张苗苗,陈雁,丛欣莹.MR体素内不相干运动成像评价膀胱尿路上皮癌病理分级及肌层侵犯[J].中国医学影像技术,2018,34(4):595~600 |
| MR体素内不相干运动成像评价膀胱尿路上皮癌病理分级及肌层侵犯 |
| Intravoxel incoherent motion MRI for prediction of histological grade and muscle invasion in bladder urothelial carcinoma |
| 投稿时间：2017-09-25 修订日期：2018-01-22 |
| DOI：10.13929/j.1003-3289.201709137 |
| 中文关键词: 膀胱尿路上皮癌 体素内不相干运动 病理分级 T分期 |
| 英文关键词:Bladder urothelial carcinoma Intravoxel incoherent motion Pathological grade T stage |
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| 中文摘要: |
| 目的 探讨MR体素内不相干运动成像（IVIM）在膀胱尿路上皮癌病理分级及肌层侵犯中的应用价值。方法 将60例经手术及病理证实的膀胱尿路上皮癌患者分为低级别（LG）和高级别（HG）组、非肌层侵犯（NMIBC）和肌层侵犯（MIBC）组。比较组间IVIM参数[表观弥散系数标准值（ADCst）、慢扩散系数（D）、灌注分数（f）和快扩散系数（D*），建立二元Logistic回归模型，计算IVIM参数两两组合的预测概率值；绘制IVIM参数及其组合预测概率值的ROC曲线，并评价其诊断效能。结果 HG组ADCst、D和f值低于LG组（P均<0.05），其ROC曲线下面积（AUC）分别为0.88、0.86、0.72（P均<0.01）；ADCst和D、ADCst和f、D和f组合预测概率值的AUC分别为0.91、0.90和0.88（P均<0.000 1）。MIBC组ADCst、D和f值低于NMIBC组（P均<0.000 1），其AUC分别为0.91、0.85和0.88（P均<0.000 1）；ADCst和D、ADCst和f、D和f组合预测概率值的AUC值均为0.93（P均<0.000 1）。结论 ADCst、D和f值越低，提示膀胱尿路上皮癌病理分级越高，侵犯肌层可能性越大；IVIM多参数组合可提高诊断效能。 |
| 英文摘要: |
| Objective To observe the utility value of MR intravoxel incoherent motion (IVIM) in histological grading and muscle invasion of bladder urothelial carcinoma. Methods According to postoperative histologic grade and T staging, 60 patients with bladder urothelial carcinoma confirmed by surgery and pathology were divided into low grade (LG) group and high grade (HG) group, as well as muscle-noninvasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) group. MR IVIM parameters (apparent diffusion coefficient standard[ADCst], true diffusion coefficient[D], pseudodiffusion coefficient[D*] and perfusion fraction[f]) were compared with independent-samples t tests. A binary Logistic regression model was established to evaluate the predicted probability of combined IVIM parameters. ROC curves of IVIM parameters and their combination`s predicted probability were drawn, and the diagnostic efficiency was evaluated. Results ADCst, D and f values of HG group were significantly lower than those of LG group (all P<0.05). Area under ROC curve (AUCs) for ADCst, D and f value to differentiate HG from LG were 0.88, 0.86 and 0.72, respectively (all P<0.01), and AUCs for predicted probability of combined ADCst and D, combined ADCst and f and combined D and f were 0.91, 0.90 and 0.88, respectively (all P<0.0001). ADCst, D and f values of MIBC group were significantly lower than those of NMIBC group (all P<0.0001). AUCs for ADCst, D and f value to differentiate MIBC from NMIBC were 0.91, 0.85 and 0.88, respectively (all P<0.0001), and all AUCs for predicted probability of combined ADCst and D, combined ADCst and f and combined D and f were both 0.93(all P<0.0001). Conclusion Lower ADCst, D and f values may indicate greater possibility of high grade and muscle invasion of bladder urothelial carcinoma. Combination of IVIM parameters can improve diagnostic efficacy. |
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