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VALUE OF DIAGNOSTIC MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING IN ASSESSING MUSCLE INVASION IN PATIENTS WITH BLADDER CANCER
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Abstract
Objectives: To investigate the imaging characteristics of multiparametric magnetic resonance imaging in the evaluation of bladder cancer. Subjects and Methods: A prospective descriptive study was conducted on 39 patients with suspected bladder cancer who underwent mpMRI and surgical pathological examination at the 108 Military Central Hospital from September 2024 to July 2025. Imaging features of bladder cancer were assessed on mpMRI, including T2-weighted imaging (T2W), diffusion-weighted imaging/apparent diffusion coefficient (DWI/ADC), and dynamic contrast-enhanced (DCE) sequences. The imaging findings were compared with postoperative histopathology. Results: A total of 39 patients with bladder cancer underwent multiparametric MRI. The mean age of the study population was 64.8 ± 12.3 years, with a male-to-female ratio of 4:1. Most patients were admitted with hematuria, accounting for 71.8%. The most common tumor location was the right bladder wall (38.5%), followed by the left wall (35.9%). Patients with a single tumor represented the largest proportion (69.2%), with one patient presenting with up to 10 tumors. Bladder tumors were most frequently found in the 11–30 mm size group, and the mean tumor size was 19.9 ± 13.7 mm. Papillary tumors without stalk were the most common type (63.6%). No flat lesions were identified. On T2-weighted sequences, most lesions demonstrated intermediate signal intensity (97%). On DWI, all lesions (100%) showed diffusion restriction, appearing hyperintense on DWI and hypointense on the ADC map. On T1-weighted sequences, the tumors predominantly exhibited low signal intensity (97%), with only 3% showing high signal intensity. Dynamic contrast-enhanced (DCE) imaging showed that the majority of tumors (90.9%) enhanced early at 20 seconds, while 9.1% demonstrated delayed enhancement at 60 seconds. No tumors were non-enhancing. Conclusion: Multiparametric MRI plays an important role in the early detection and treatment planning of bladder cancer.
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Keywords
bladder cancer, multiparametric magnetic resonance imaging, mpMRI.
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