首页> 外文期刊>Scandinavian journal of urology >Preoperative staging of locally advanced bladder cancer before radical cystectomy using 3 tesla magnetic resonance imaging with a standardized protocol
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Preoperative staging of locally advanced bladder cancer before radical cystectomy using 3 tesla magnetic resonance imaging with a standardized protocol

机译:根治性膀胱切除术前局部晚期膀胱癌的术前分期,采用3 tesla磁共振成像和标准化方案

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Objective. The correlation between clinical tumour stage and pathological tumour stage in radical cystectomy specimens in locally advanced bladder cancer is suboptimal. Radiological methods have so far been of limited value in preoperative staging; however, the resolution with magnetic resonance imaging (MRI) has improved with further technical developments of the method. The aim of this study was to compare tumour stage at MRI with pathological tumour stage in the cystectomy specimen. Material and methods. Prospectively, 53 patients with invasive bladder cancer were preoperatively investigated with 3 tesla (3T) MRI using a standardized protocol. 3T MRI was performed at a standardized bladder volume. Clinical tumour stage, tumour stage at MRI and pathological tumour stage groups (Ta, Cis, T1/T2a, T2b/T3a, T3b/T4a), were compared, and sensitivity and specificity for organ-confined and non-organ-confined disease (stage T3a or above or lymph-node metastases) were analysed. Results. MRI overestimated tumour stage in 23 out of 47 patients (49%), whereas six patients (13%) were understaged. In the three groups of patients (those with the same stage group at MRI as in the cystectomy specimen, overestimated tumour stage and understaged patients), the time interval between transurethral resection of the bladder (TURB) and MRI did not differ significantly. Conclusions. Preoperative MRI overestimated tumour stage in almost half of the patients investigated in this study. Postoperative changes could have contributed to such overstaging with MRI.
机译:目的。在局部晚期膀胱癌的根治性膀胱切除术标本中,临床肿瘤分期与病理性肿瘤分期之间的相关性欠佳。迄今为止,放射学方法对术前分期的价值有限。然而,随着该方法的进一步技术发展,磁共振成像(MRI)的分辨率得到了提高。这项研究的目的是比较膀胱切除标本的MRI肿瘤分期与病理性肿瘤分期。材料与方法。前瞻性地,对53例浸润性膀胱癌患者进行了术前3特斯拉(3T)MRI标准化检查。在标准膀胱体积下进行3T MRI。比较了临床肿瘤分期,MRI肿瘤分期和病理性肿瘤分期组(Ta,Cis,T1 / T2a,T2b / T3a,T3b / T4a),并比较了器官受限和非器官受限疾病的敏感性和特异性( T3a期以上或淋巴结转移)进行了分析。结果。 MRI高估了47位患者中的23位(49%)的肿瘤分期,而6位患者(13%)的肿瘤分级不足。在三组患者中(与膀胱切除术标本在MRI上具有相同分期的患者,高估了肿瘤分期和低分期的患者),经尿道膀胱电切术(TURB)和MRI之间的时间间隔没有显着差异。结论这项研究中,几乎一半的患者术前MRI高估了肿瘤的分期。术后改变可能导致MRI过度分期。

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