膀胱肉瘤样尿路上皮癌的 CT 和 MRI 特征及其与传统尿路上皮癌的鉴别诊断。

IF 3.5 2区 医学 Q2 ONCOLOGY Cancer Imaging Pub Date : 2024-08-02 DOI:10.1186/s40644-024-00748-x
Jiayi Zhuo, Jingjing Han, Lingjie Yang, Yu Wang, Guangzi Shi, Zhuoheng Yan, Lu Yang, Riyu Han, Fengqiong Huang, Xiaohua Ban, Xiaohui Duan
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引用次数: 0

摘要

背景:肉瘤样尿路上皮癌(SUC)是一种罕见的高度恶性膀胱癌,预后较差。目前,关于膀胱肉瘤样尿路上皮癌(SUC)的影像学特征以及将其与传统尿路上皮癌(CUC)区分开来的可靠指标的信息非常有限。我们的研究旨在确定膀胱癌的独特影像学特征,并确定有助于其鉴别诊断的因素:这项回顾性研究共纳入 22 名膀胱 SUC 患者和 61 名 CUC 患者。记录了两组患者的临床、病理和 CT/MRI 数据,并采用单变量分析和多项式逻辑回归进行比较,以区分 SUC 和 CUC:结果:大多数 SUC 位于膀胱三叉部,肿瘤体积大、形状不规则、ADC 值低、膀胱影像报告和数据系统(VI-RADS)评分≥ 4、存在坏死和侵袭性。单变量分析表明,在肿瘤位置、形状、最大长轴直径(LAD)、短轴直径(SAD)、ADC 值、VI-RADS 评分、坏死、膀胱外扩展(EVE)、盆腔腹膜扩散(PPS)和肾积水/输尿管积水等方面存在显著差异(P 结论:膀胱 SUC 表现出几种不同的影像学特征:膀胱 SUC 具有几个明显的影像学特征,包括三叉神经受累发生率高、肿瘤体积大、侵袭性明显并伴有坏死。具有较大 SAD 和坏死证据的膀胱肿瘤更有可能是 SUC,而不是 CUC。
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CT and MRI features of sarcomatoid urothelial carcinoma of the bladder and its differential diagnosis with conventional urothelial carcinoma.

Background: Sarcomatoid urothelial carcinoma (SUC) is a rare and highly malignant form of bladder cancer with a poor prognosis. Currently, there is limited information on the imaging features of bladder SUC and reliable indicators for distinguishing it from conventional urothelial carcinoma (CUC). The objective of our study was to identify the unique imaging characteristics of bladder SUC and determine factors that aid in its differential diagnosis.

Materials and methods: This retrospective study enrolled 22 participants with bladder SUC and 61 participants with CUC. The clinical, pathologic, and CT/MRI data from both groups were recorded, and a comparison was conducted using univariate analysis and multinomial logistic regression for distinguishing SUC from CUC.

Results: The majority of SUCs were located in the trigone of the bladder and exhibited large tumor size, irregular shape, low ADC values, Vesical Imaging-Reporting and Data System (VI-RADS) score ≥ 4, the presence of necrosis, and an invasive nature. Univariate analysis revealed significant differences in terms of tumor location, shape, the maximum long-axis diameter (LAD), the short-axis diameter (SAD), ADC-value, VI-RADS scores, necrosis, extravesical extension (EVE), pelvic peritoneal spread (PPS), and hydronephrosis/ureteral effusion (p < .001 ~ p = .037) between SUCs and CUCs. Multinomial logistic regression found that only SAD (p = .014) and necrosis (p = .003) emerged as independent predictors for differentiating between SUC and CUC. The model based on these two factors achieved an area under curve (AUC) of 0.849 in ROC curve analysis.

Conclusion: Bladder SUC demonstrates several distinct imaging features, including a high incidence of trigone involvement, large tumor size, and obvious invasiveness accompanied by necrosis. A bladder tumor with a large SAD and evidence of necrosis is more likely to be SUC rather than CUC.

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来源期刊
Cancer Imaging
Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.
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