Clinical value of high-resolution T2-weighted magnetic resonance imaging combined with readout-segmented echo-planar imaging in differential diagnosis of muscle and non-muscle invasive bladder cancer / 第二军医大学学报

ABSTRACT

Objective To evaluate the clinical value of high-resolution T2-weighted magnetic resonance imaging (HR-T2WI), readout-segmented echo-planar imaging (RS-EPI) and HR-T2WI plus RS-EPI in differentiating non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC). Methods A prospective study was conducted on 95 patients with bladder cancer identified by cystoscope biopsy, who underwent surgery treatment in our hospital from Jun. 2016 to Dec. 2017. All 95 patients had clear pathological staging, and received HR-T2WI and RS-EPI examination. NMIBC and MIBC were differentiated using HR-T2WI, RS-EPI and HR-T2WI plus RS-EPI, and the diagnosis results were compared with the pathological results using Kappa test. The receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) of ROC was calculated to evaluate the sensitivity, specificity, accuracy of HR-T2WI, RS-EPI and HR-T2WI plus RSEPI. DeLong test was used to compare the AUC of three methods. Results The diagnostic results of HR-T2WI, RS-EPI and HRT2WI plus RS-EPI had good agreement with the pathological results (Kappa=0.770, 0.787 and 0.936; all P<0.01). The AUC, sensitivity, specificity and accuracy of HR-T2WI, RS-EPI and HR-T2WI plus RS-EPI were 0.899, 95.5% (42/44), 82.4% (42/51) and 88.4% (84/95), 0.891, 84.1% (37/44), 94.1% (48/51) and 89.5% (85/95), and 0.966, 93.2% (41/44), 100.0% (51/51) and 96.8% (92/95), respectively. The AUC of HR-T2WI+RS-EPI was higher than that of HR-T2WI and RS-EPI (Z=-2.627 8 and -2.720 5, P=0.008 6 and 0.006 5). Conclusion HR-T2WI plus RS-EPI can be used as a preoperative non-invasive examination method to differentiate NMIBC and MIBC.