Correlation Study Of Multi-parameter MRI With Muscular Infiltration And Pathological Grade Of Bladder Cancer

Objective:To evaluate the diagnostic value of conventional T2-weighted imaging（T2WI）,diffusion-weighted imaging（DWI）and Dynamic contrast augmention-MRI（DCE-MRI）in muscular infiltration of bladder cancer.The Apparent diffusion coefficient（ADC）value,area size,and Standard apparent diffusion coefficient（ADC）value of lesions was compared in order to study their relationship with different pathological grades and muscular infiltration of bladder cancer.Methods:Data of 125 patients with bladder urothelial carcinoma from the Second Affiliated Hospital of Kunming Medical University from January 2020 to December 2021 were collected.Routine T2WI,DWI and DCE-MRI sequence scanning were performed.multiparmetric MRI was analyzed according to the comprehensive diagnosis results of physicians.The diagnostic efficacy of mp MRI in MIBC.ADC images generated when b value=1000 s/mm²were used to measure the ADC value,area size and n ADC value of the lesions.Mann Whitney U test and independent sample T test were used to compare the value of the above three parameters in the diagnosis of different pathological grades and MIBC,and Pearson and Spearman rank correlation test was used to evaluate their correlation with MIBC and pathological grades,and ROC curve was drawn to analyze the diagnostic efficacy of MIBC and different pathological grades of bladder cancer.Results:There were 51 cases in MIBC group and 74 cases in NMIBC group.There were 53 cases in LG group,55 cases in HG group and 17 cases in mixed group.The sensitivity,specificity,PPV,NPV and accuracy of conventional T2WI,DWI and DCE-MRI were 84.0%,94.0%,92%,88%,90%.The average ADC value in the NMIBC group was higher than that in the MIBC group,and the ADC value was moderately negatively correlated with muscle infiltration.The AUC of ADC value was 0.675（P<0.05）,and the threshold value was 1.23×10^-3mm²/s.The sensitivity and specificity of the ADC value in the diagnosis of muscle infiltration were 58.8%and 81.1%,respectively.The lesion area in NMIBC group was smaller than that in MIBC group,and there was a moderate positive correlation between lesion area and muscle infiltration,with statistical significance（P<0.05）.The AUC of lesion area was 0.759（P<0.05）,the threshold value was 6.40 cm2,and the diagnostic sensitivity and specificity were 59.5%and 68.6%.The average ADC value of LG group was higher than that of HG group,and the ADC value was highly negatively correlated with the pathological grade of bladder cancer.The AUC of ADC value was 0.905（P<0.05）,the threshold was 1.17×10^-3mm²/s,and the diagnostic sensitivity and specificity were 98.1%and 76.4%,respectively.The lesion area of LG group was smaller than that of HG group,and was moderately positively correlated with pathological grade,the difference was statistically significant（P<0.05）.The AUC of lesion area was 0.7,the optimal threshold was 2.78 cm2,and the diagnostic sensitivity and specificity were 81.8%and 52.8%,respectively.ADC,n ADC1 and n ADC2 values in MIBC group were significantly lower than those in NMIBC group,and the differences were statistically significant（P<0.05）.The AUC values of ADC,n ADC1 and n ADC2were 0.675,0.684 and 0.655,respectively,and the sensitivity and specificity were58.8%,respectively.81.1%,51.4%,78.4%,66.2%,58.8%,the correlation coefficients of the three with muscular invasive bladder cancer were-0.31,-0.318,-0.243,respectively.ADC,n ADC1 and n ADC2 values were significantly different in HG group and LG group（P<0.05）.The AUC values of ADC,n ADC1 and n ADC2 were0.905,0.879 and 0.842,respectively,and the sensitivity and specificity of the three were 98.1%,76.4%,98.1%,65.5%,92.5%and 72.7%,respectively.The values of ADC,n ADC1 and n ADC2 were negatively correlated with the pathological grade of bladder cancer.The correlation coefficients were-0.691,-0.653 and-0.591,respectively.Conclusion（s）:The combination of MRI conventional T2WI,DCE-MRI and DWI has high accuracy in the diagnosis of muscular infiltration of bladder cancer,and should be advocated in the preoperative assessment of bladder cancer staging.ADC value is helpful to improve the accuracy of preoperative diagnosis of muscular invasion and pathological grading of bladder cancer.Lesion size can also be used as an auxiliary diagnostic indicator to reflect the aggressiveness of bladder cancer and the degree of muscular invasion.n ADC value is inferior to ADC value in relation to bladder cancer and diagnostic value.