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目的:总结膀胱癌的MRI征象,探讨MRI对膀胱癌分期的作用及鉴别诊断要点。方法:对探讨经手术与病理证实23例膀胱癌的MRI回顾性对比分析。其中男性,19例,女性,4例,年龄50~90岁,平均年龄70岁。18例行MRI增强检查。结果:膀胱三角区及膀胱后侧壁是最常见好发部位,表现为膀胱壁突向腔内肿块和(或)膀胱壁局限性不规则增厚;肿瘤平扫T1WI等或略高信号,T2WI呈高信号,Gd-DTPA动态增强早期肿块显著强化。根椐肿瘤生长方式可分为:①小结节型,②广基肿块型,③浸润型。MRI对膀胱癌定位、定性诊断正确率分别为95.7%(22/23)、91.3%(21/23);术前MRI诊断与TNM分期符合率为82.3%(19/23),MRI较病理分期偏高。结论:膀胱癌的MRI表现具有独特性。T1加权主要用于肿瘤的定性诊断,T2加权主要用于肿瘤的术前分期;MRI检查多方位、多序列成像,是显示膀胱癌最理想的检查方法。
OBJECTIVE: To summarize the MRI features of bladder cancer and explore the role of MRI in the staging of bladder cancer and the main points of differential diagnosis. Methods: MRI retrospective analysis of 23 cases of bladder cancer confirmed by surgery and pathology. Including males, 19 cases, females, 4 cases, aged 50 to 90 years old, with an average age of 70 years. 18 routine MRI enhanced examination. Results: The bladder trigone and the posterior wall of the bladder were the most common sites of invasion. The lesions showed irregular localized thickening of the tumor and / or bladder wall in the bladder wall. Tumors such as T1WI or slightly higher signal, T2WI High signal, Gd-DTPA dynamic enhanced early mass was significantly enhanced. Root 椐 tumor growth can be divided into: ① nodules, ② wide-based mass type, ③ infiltration type. The correct rate of MRI diagnosis of bladder cancer was 95.7% (22/23) and 91.3% (21/23), respectively. The coincidence rate of preoperative MRI and TNM staging was 82.3% (19/23) High. Conclusion: MRI manifestations of bladder cancer are unique. T1-weighted mainly used for the qualitative diagnosis of tumors, T2-weighted tumor mainly used for preoperative staging; MRI multi-orientation, multi-sequence imaging, bladder cancer is the best way to check.