VAI TRÒ CỦA CỘNG HƯỞNG TỪ TRONG CHẨN ĐOÁN PHÂN ĐỘ GIAI ĐOẠN T UNG THƯ BÀNG QUANG

Abstract

Objective: Describing imaging characteristics and assessing values of MRI in the diagnosis of bladder cancer at T-stage. Subjects and Methods: 40 patients with bladder cancer, undergo pelvic MRI, diagnosed, operated, and had pathology results from 01/06/2019 to 31/10/2022 at Binh Dan hospital. All MRI films were evaluated preoperatively and compared with histopathology postoperatively. Results: Among 40 patients being studied, the mean age was 61,25 ± 15,34; male predominance (67%). Histopathological results showed that transitional cell cancer accounted for the majority with 37 cases (92,5%), squamous cell cancer accounted for 7,5%. Out of 85 tumors, the most common tumor location was bilateral bladder 42%, mostly one tumor (70%). Featured images: mean size 18,18 ± 17,18; most frequently found polyp-shaped tumor 42,5%. There was a strong correlation between the shape and size of tumors and T staging (p<0.001). Most polypoid tumors were non-muscle invasive (76,5%). On T2 sequences, most tumors had intermediate signal (92,5%), low signal accounted for 7,5%. The value of sequences when in distinguishing tumors in T1 or lower and tumors in T2 or higher when using T2 sequences alone had the sensitivity, specificity and overall accuracy of 78,3%; 41,2%, 62,5%, accordingly. When combining T2 and DCE, these rates are 95,7%; 58,8%; 80%; when combining T2 and DWI these rates were 91,3%; 82,4%;87,5%. These rates were 95,7%; 88,2%; 92,5%, respectively, when combining 3 sequences T2, DCE and DWI. The area under the curve (AUC) for the VI-RADS scale in distinguishing muscle invasive of bladder was 0,948, with cut-off of 3 giving the highest sensitivity and specificity in diagnosis, 96,7% and 82,4% respectively.  Conclusion: MRI is an accurate method of bladder cancer for T-staging, helping clinicians having appropriate treatment plan for patients.