The Value Of Contrast-Enhanced Ultrasound And Magnetic Resonance Imaging In The Diagnosis Of Bladder Cancer

Background: Imaging examination,tumor marker detection,bladder biopsy and other methods are the main methods for the diagnosis of bladder cancer.But there is no standard for the evaluation of the staging of bladder cancer and the appearance of the muscle invasive in the clinical imaging examination.In this study,a variety of diagnostic methods were analyzed,trying to find a non-invasive and accurate method for bladder cancer T staging and muscle invasive.Objective: To evaluate contrast-enhanced ultrasonography(CEUS)and magnetic resonance diffusion-weighted imaging(DWI)alone and their combination in the diagnosis and staging of bladder cancer T staging.Analysis of contrast-enhanced ultrasound,magnetic resonance diffusion-weighted imaging,quantization apparent diffusion coefficient(ADC)and p63 gene alone and their combination in diagnosis of the evaluation of bladder cancer muscle invasive.Methods: Retrospectively analyses the patients in our hospital from September2012 to December 2015,whose diagnose is bladder tumor and had contrast enhanced ultrasound and magnetic resonance diffusion weighted imaging.All patients underwent surgical treatment,definite pathological stage and the expression of p63 gene.Analysis different diagnostic methods of sensitivity,specificity and accuracy.Quantitative apparent diffusion coefficient.Use receiver operating characteristic(ROC)curve to calculate the bladder muscle invasive of ADC threshold,the threshold calculated the diagnostic sensitivity,specificity and accuracy.Through the analysis of the series and parallel combined diagnosis method combined with diagnostic sensitivity,specificity and accuracy.Results: CEUS and MRI+DWI examination for bladder cancer T staging accuracy were 74.6% and 76.3%,the two combined diagnosis accuracy was 91.5%,compared with the single diagnostic is significantly improved.CEUS,MRI+DWI,ADC and p63 gene expression in muscle invasive bladder cancer the diagnosis accuracy were 81.4%,83.1%,84.7% and 69.5%.CEUS parallel combined with MRI+DWI diagnostic accuracy of 91.5%,compared with the single diagnostic accuracy is significantly improved.CEUS,MRI+DWI combined with p63 gene diagnosis,diagnostic accuracy has no obvious difference,but the sensitivity of specific diagnosis and diagnosis of parallel series was compared with the single check upgrade.Four joint diagnosis,if diagnosis when two prompt muscle invasive,diagnostic sensitivity,specificity and accuracy were significantly improved,100%,97.1% and 98.3% respectively.Conclusion: CEUS and MRI + DWI combined diagnosis choosing the higher T stage,is more valuable for bladder cancer patients T staging;CEUS and MRI + DWI examination and p63 gene combined diagnosis improve the diagnostic sensitivity and specificity without decreasing accuracy rate;CEUS,MRI + DWI and quantitative ADC value and p63 gene combined with diagnosis,if we make diagnosis two prompt muscle invasive,will effectively improve muscle invasive bladder cancer diagnosis rate.