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首页> 外文期刊>Acta Radiologica >Bladder cancer: Utility of MRI in detection of occult muscle-invasive disease
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Bladder cancer: Utility of MRI in detection of occult muscle-invasive disease

机译：膀胱癌：MRI在检测隐匿性肌肉浸润性疾病中的实用性

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Background: The presence of muscularis propria invasion by bladder cancer is a key factor in prognosis and treatment decisions, although may be missed by biopsy due to sampling error. MRI has shown potential for detection of muscle invasion but has not specifically been evaluated for this purpose in the setting of bladder cancer patients without evidence of muscle invasion on initial biopsy. Purpose: To evaluate the role of MRI in detection of muscularis propria invasion by bladder cancer following a pathologic diagnosis of non-invasive tumor. Material and Methods: This retrospective study included 23 patients who underwent pelvic MRI following a pathologic diagnosis of bladder cancer without muscularis propria invasion and in whom additional histologic evaluation was performed following MRI. Two radiologists in consensus reviewed T2-weighted images to identify those cases suspicious for muscle invasion on MRI. The radiologists identified whether cases suspicious for invasion demonstrated disruption of the T2-hypointense muscularis layer of the bladder wall, peri-vesical fat stranding, and peri-vesical soft tissue nodularity. Findings were compared with pathologic results obtained after MRI. Results: Suspicion was raised for muscle invasion in eight of 23 cases, four of which exhibited invasion on follow-up pathology. No case without suspicion on MRI exhibited invasion on follow-up pathology. Therefore, sensitivity and specificity were 100% and 79%, respectively. Among individual findings, muscularis disruption on T2WI exhibited sensitivity of 100% and specificity of 79%, peri-vesical fat stranding exhibited sensitivity and specificity of 50% and 84%, and peri-vesical soft tissue nodularity exhibited sensitivity and specificity of 25% and 100%. Conclusion: MRI demonstrated high sensitivity for detection of muscle invasion in cases of bladder cancer without invasion on initial histologic assessment. Muscularis disruption on T2WI appeared to exhibit a better combination of sensitivity and specificity than did peri-vesical changes.
机译：背景：膀胱癌侵犯固有肌层是预后和治疗决策的关键因素，尽管活检可能由于取样误差而错过。 MRI已显示出检测肌肉浸润的潜力，但尚未在没有初步活检时出现肌肉浸润迹象的膀胱癌患者中对此进行专门评估。目的：评价MRI在非侵入性肿瘤的病理诊断后，在检测膀胱癌固有肌层浸润中的作用。资料和方法：这项回顾性研究包括23例经病理诊断为膀胱癌且无固有肌层浸润的患者接受了盆腔MRI检查，并在MRI之后进行了额外的组织学评估。两位一致同意的放射科医生审阅了T2加权图像，以识别那些可疑在MRI上侵犯肌肉的病例。放射科医生确定了可疑侵袭病例是否显示出膀胱壁的T2低水平肌层破裂，膀胱周围脂肪滞留和膀胱周围软组织结节。将检查结果与MRI后获得的病理结果进行比较。结果：23例中有8例怀疑增生，其中4例表现为侵犯。 MRI无怀疑的病例在随访病理中均未见浸润。因此，敏感性和特异性分别为100％和79％。在个体发现中，T2WI上的肌层破裂表现出100％的敏感性和79％的特异性，膀胱周围脂肪链的敏感性和特异性分别为50％和84％，膀胱周围软组织结节的敏感性和特异性为25％和100％。结论：MRI在无组织浸润的膀胱癌病例中进行组织学初步评估时具有很高的敏感性。 T2WI上的肌层破裂似乎比膀胱周围的改变表现出更好的敏感性和特异性结合。

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