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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(P<0.05);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(P<0.05)。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。
Objective: To investigate the value of magnetic resonance diffusion weighted imaging (DWI) in the diagnosis of bladder cancer. Methods: Thirty-six patients with bladder cancer underwent routine bladder MRI examination and DWI examination. The size of the lesion in the bladder tumor was determined by selecting the region of interest of the lesion, and the apparent diffusion coefficient (ADC) map was fitted. On the ADC chart Direct measurement of different b values (b = 1 200,1 500 s / mm2) and the average ADC value of bladder tumor lesions were quantified. Subsequently, the patients underwent transurethral resection of the bladder tumor within 1 week. Some patients underwent radical cystectomy and the resected tissues were sent for pathological examination. Results: Of the 36 patients, the b value was 1 500 and 1 200 s / mm 2. At the same b value, the average ADC value of bladder cancer group was lower than that of benign tumor group (748.12 ± 93.60,1 190.88 ± 86.47,803.40 ± 103.91,1 266.93 ± 89.15, respectively) (P <0.05); high grade papillary The mean ADC value of urothelial carcinoma was significantly lower than that of low grade papillary urothelial carcinoma (651.15 ± 24.82, 817.39 ± 51.71, 699.54 ± 24.13, 877.57 ± 24.13, respectively, P <0.05). Conclusion: The value of DWI and ADC in the diagnosis of malignant bladder tumor has a certain value.