Objective This study analyzed differential diagnostic value between malignant and benign bladder neoplasm by comparing the apparent diffusion coefficient (ADC) values and relative apparent diffusio coefficient (r-ADC) values on diffusion-weigyed MR imaging .Methods Between October 2012 to May 2013 ,75 consecutive patients (52~76 years old , mean 60 .4 years old) who were suspected having bladder neoplasm by ultrasound exams and finally diagnosed by cystosco-py biopsy were enrolled in this study .All patients had been performed a series sequences of MR examinations including ax-ial T1WI ,T2WI ,DWI with b factors of 0 and 1 500 s/mm2 ,axial and coronal Gd-DTPA enhanced LAVA sequences .The ADC values of the lesions and the normal bladder wall were measured and then r-ADC (r-ADC=lesion's ADC/lateral wall's ADC) value was calculated .Independent-samples T Test was applied to verify the significant differences of ADC and r-ADC value between the benign and the malignant lesions .Results All cases with malignant lesions and 4 cases with be-nign lesions were appeared as high signal intensity (SI) relative to bladder wall and the surrounding urine on DW images . The mean ADC value of the malignant bladder lesion (0 .85 ± 0 .30)× 10-3 mm2/s was significant lower than that of benign leion (1 .62 ± 0 .86)× 10-3 mm2/s( P <0 .05) .The mean r-adc values of the malignant bladder lesions (0 .74 ± 0 .27) also appeared significant lower than that of benign lesions (1 .20 ± 0 .73)( P<0 .01) .Conclusion DW imaging is a highly reli-able imaging approach for distinguishing mailignant and benign bladder neoplasm .%目的：探讨磁共振（magnetic resonance ，MR）弥散加权成像（diffusion-weighted imaging ，DWI）中的表观扩散系数（apparent diffusion coefficient ，ADC）及相对表观扩散系数（r-ADC）值在膀胱良恶性病变鉴别诊断中的应用价值。方法共收集2012年10月～2013年5月75例超声诊断为膀胱占位患者，并最终经膀胱镜病理确诊。所有患者均行常规横断位T1 WI、T2 WI、DWI（b值为0和1500s/mm2），横断位和冠状位增强LAVA序列。测量病灶及病灶对侧膀胱壁的ADC值及r-ADC值进行统计学分析。结果所有恶性膀胱肿瘤病灶及4例良性病灶在DWI图像上病灶显示为明显高信号。恶性膀胱肿瘤病灶平均ADC值（0．85±0．30）×10-3 mm2/s明显低于良性病灶的 ADC值（1．62±0．86）×10-3 mm2/s）（ P ＜0．05）。恶性肿瘤性病灶的r-ADC值（0．74±0．27）也明显低于良性肿瘤性病灶（1．20±0．73）（ P ＜0．01）。结论结论DWI在鉴别膀胱良恶性肿瘤中有较高的应用价值，是一种较可靠的检查方法。
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