| Objective:To investigate the value of magnetic resonance imaging?MRI?in staging of bladder cancer and evaluating the clinical application of apparent diffusion coefficient?ADC?in grading and predicting the recurrence of bladder cancer.Materials and Methods:A retrospective analysis was performed in a total of 113 patients with pathologically confirmed bladder cancer in this study.Routinely examination of 1.5T magnetic resonance imaging and diffusion-weighted imaging were performed on each case,and measured the ADC value of tumor respectively?b=800s/mm2?.Diagnosing the neoplasm staging by MRI,Then compared the results between imaging diagnosing and pathological diagnosing,and the pathological result was regarded as the standard.Meanwhile,24 patients with the same T stage who underwent transurethral resection of bladder cancer were followed up after discharged to investigate the relationship between tumor recurrence and ADC values.Results:There were 88 cases of muscle-invasive bladder cancer?MIBC?,24cases of non-muscle invasive bladder cancer,and 1case of normal appearance.And the pathological results of MIBC and NMIBC were 79and 34,respectively,including one case of carcinoma in situ.The concordance of staging between MRI and pathology was 83.2%,and the average ADC value of total cases?high-grade cancer and low-grade cancer was?0.93±0.28?×10-3mm2/s??0.79±0.20?×10-3?2/s??1.14±0.25?×10-3?2/s,respectively.There was a significantly statistical difference in ADC value among different pathological grading bladder carcinomas,and the result shown an negative correlation between pathological grading and ADC values?r=-0.61,P<0.05?.According to the ROC analysis,The best cut-off ADC value for discriminating NMIBC from MIBC was 0.955×10-3mm2/s,with the sensitivity of 76.6%and specificity of 81.8%.However,there was no statistical difference of ADC values between recurrence and no recurrence?P>0.05?.Conclusion:1.The application of MRI can significantly improve the accuracy of preoperative staging bladder cancer,especially for discriminating MIBC from NMIBC.2.The ADC value can be used as an indicator in grading of tumor,which is conducive to the comprehensive preoperative evaluation of bladder cancer. |
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