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Master's Dissertation
DOI
Document
Author
Full name
Diego Armando Effio Solis
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Muglia, Valdair Francisco (President)
Macedo, Tulio Augusto Alves
Júnior, Jorge Elias
Reis, Rodolfo Borges dos
Title in Portuguese
Avaliação da melhor sequência de ressonância magnética para definição do envolvimento muscular na neoplasia vesical maligna
Keywords in Portuguese
Estadiamento de neoplasias
Imagem por ressonância magnética
Neoplasia da bexiga urinária
Abstract in Portuguese
OBJETIVO: Avaliar a acuidade diagnóstica da Ressonância Magnética na determinação da invasão da camada muscular, no estadiamento das neoplasias vesicais malignas. MATERIAIS E MÉTODOS: Este foi um estudo retrospectivo, em uma mesma instituição, incluindo os pacientes com diagnóstico histológico comprovado de neoplasia vesical maligna e que tiveram exame de RM realizado com intervalo de até 4 meses em relação ao procedimento cirúrgico. Dois observadores, sem acesso às informações clínicas e anatomopatológicas, avaliaram as imagens de RM, inicialmente apenas T2 e em seguida apenas as imagens de difusão. Os resultados foram confrontados com achados histopatológicos. RESULTADOS: Trinta pacientes, sendo 4 mulheres (13,3%) e 26 homens (86,7%), com idade média de 63,9 anos (48-91 anos) foram analisados. O tamanho médio da lesões foi 4,3 cm +/- 2,9 cm. Em relação à morfologia das lesões, o observador 1 classificou 20 (66,7%) como papilares, 8 como planas (26,6%) e 2 como endofíticas (6,7%) e o observador 2, o 20 papilares (66,7%), 7 planas (23,3%) e 3 endofíticas (10,0%) Carcinoma urotelial foi o diagnóstico histológico de 29 lesões (96,7%) e um adenocarcinoma (3,3%). A sensibilidade, especificidade, valor preditivo positivo, negativo e acuidade para o observador 1, foi de 92,9%, 62,5%, 68,4%, 90,9% e 76,7% e para o observador 2, 85,7%, 75%, 75,%, 85,1% e 80,0%, respectivamente. CONCLUSÃO: As sequências ponderadas em T2 apresentaram uma tendência, em ambos os observadores, a superestimar a presença de invasão da musculatura detrusora vesical em pacientes com neoplasia de bexiga. As imagens por difusão apresentaram uma tendência de melhor acuidade diagnóstica para ambos os observadores
Title in English
Evaluation of the best magnetic resonance sequence to define muscle involvement in malignant bladder neoplasms
Keywords in English
Magnetic resonance imaging
Neoplasm staging
Neoplasms of the urinary bladder
Abstract in English
PURPOSE: To evaluate the diagnostic accuracy of magnetic resonance imaging in the determination of invasion of the muscular layer, when staging malignant bladder neoplasms. MATERIALS AND METHODS: This was a retrospective, single-institution study, including patients with a proven histological diagnosis of malignant bladder neoplasia, who underwent MRI examination with an interval of up to 4 months in relation to the surgical procedure. Two observers, blinded to clinical and pathological data, assessed MR images, initially only T2, and then only the diffusion images. The results were confronted with histopathological findings. RESULTS: Thirty patients, 4 women (13.3%) and 26 men (86.7%), with a mean age of 63.9 years (48-91 years) were analyzed. The mean lesion size was 4.3 cm +/- 2.9 cm. For the morphology of the lesions, observer 1 classified 20 (66.7%) as papillary, 8 as flat (26.6%) and 2 as endophytic (6.7%) and observer 2, 20 papillary (66 7%), 7 flat (23.3%) and 3 endophytic (10.0%). Urothelial carcinoma was the histological diagnosis of 29 lesions (96.7%) and one was adenocarcinoma (3.3%). The sensitivity, specificity, positive predictive value, negative and acuraccy for the observer 1 was 92.9%, 62.5%, 68.4%, 90.9% and 76.7%, and for the observer 2, 85.7%, 75.0%, 75.0%, 85.1% and 80.0%, respectively. CONCLUSION: The T2-weighted sequence showed a tendency, for both observers, to overestimate the presence of bladder detrusor muscle invasion in patients with bladder cancer. The DWI images showed a tendency to better diagnostic accuracy when compared to T2
 
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Publishing Date
2019-08-29
 
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