【摘要】 目的:探讨基于DWI影像特征及定量分析参数对DWI VI-RADS 2分带蒂膀胱癌的肌层浸润性评估价值。方法:回顾性搜集2020年9月-2021年12月经手术病理证实的54例膀胱癌患者临床及MR影像资料，所有患者DWI VI-RADS均为2分，据病理结果分为非肌层浸润性膀胱癌(NMIBC,31例)和肌层浸润性膀胱癌(MIBC,23例)。采用独立样本t检验、Mann-Whitney U检验、卡方检验比较两组之间临床特征、影像定性及定量参数的差异，单因素分析获得具有统计学意义的参数，采用受试者工作特征(ROC)曲线评估各定量参数对DWI VI-RADS 2分膀胱癌肌层浸润评估的诊断效能，并计算定量参数的最佳截断值。结果:单因素分析显示MIBC组与NMIBC组在肿瘤病理分级、肿瘤形态及蒂形态方面差异具有统计学意义(P<0.01)。带蒂测量的MIBC组ADC值低于NIMIBC组，差异具有统计学意义(P<0.05),不带蒂测量的MIBC组ADC值低于NMIBC组，但差异无统计学意义(P=0.08)。带蒂ADC、蒂最宽、宽度比、肿瘤形态、蒂形态、蒂居中及基底部光滑预测DWI VI-RADS 2分膀胱癌肌层浸润的AUC分别为0.67、0.69、0.83、0.74、0.84、0.78、0.63。结论:带蒂ADC值、肿瘤形态及蒂形态对预测DWI VI-RADS 2分膀胱癌肌层浸润具有一定的诊断帮助，以肿瘤蒂形态及宽度比较为显著。更多还原

【Abstract】 Objective:To investigate the value of DWI imaging features and quantitative analysis parameters in the evaluation of muscle invasion in DWI VI-RADS 2 bladder cancer.Methods:The clinical and MR imaging data of 54 patients with bladder cancer confirmed by surgical pathology from September 2020 to December 2021 were retrospectively collected.The DWI VI-RADS scores of all patients were 2-point.According to the pathological results, all patients were divided into non-muscle-invasive bladder cancer(NMIBC,31 cases) and muscle-invasive bladder cancer(MIBC,23 cases).Independent sample t test, Mann-Whitney U test and Chi-square test were used to compare the differences in clinical features, image qualitative and quantitative parameters between these two groups.Statistically significant parameters were obtained by one-way analysis of variance, receiver operating characteristic(ROC) curve was used to evaluate the diagnostic effect of each quantitative parameter in the 2-point DWI VI-RADS evaluation on muscle infiltration of bladder cancer, and the optimal cutoff values of quantitative parameters were calculated.Results:Univariate regression analysis showed that there were significant differences in tumor pathological grade, tumor morphology and stalk morphology between MIBC group and NMIBC group(P<0.01).The ADC value of MIBC group with stalk measurement was lower than that of NIMIBC group, and the difference was statistically significant(P<0.05).ADC values in the MIBC group without stalk were lower than those in the NMIBC group, but the difference was not statistically significant(P=0.08).The AUC of ADC value with stalk, stalk width, width ratio, tumor shape, stalk shape, stalk centrality, and basal smoothness predicting DWI VI-RADS-2 muscle invasion were 0.67,0.69,0.83,0.74,0.84,0.78,and 0.63,respectively.Conclusion:ADC value with stalk, tumor morphology and stalk morphology can help predict muscle invasion of DWI VI-RADS-2,and the stalk shape and width ratio are of great significance.更多还原