目的探讨不同磁共振功能成像 (MRI)序列检查在膀胱癌患者T分期评估 诊断中的应用价值差异。方法 选取2013 年5月-2014年10月于我院就诊且经外科 手术或病理检查确诊的128例膀胱癌患者 为研究对象，均对其予以不同MRI序列检 查。以外科手术或病理检查结果为“金标 准”，评估常规MR平扫、常规MR平扫+扩 散加权成像(DW-MRI)扫描及常规MR平扫 +DW-MRI扫描+动态增强(DCE-MRI)扫描等 三种MRI序列检查方案在膀胱癌患者T分期 评估诊断中的特异性、敏感性及准确性差 异。结果 此次入组的128例膀胱癌患者经 外科手术或病理检查，确诊为膀胱壁肌层 无浸润者83例(64.8%)，膀胱壁肌层浸润 者45例(35.2%)。常规MR+DWI+DCE-MRI方 案正确诊断肌层浸润43例，正确诊断无肌 层浸润75例，其中假肌层浸润8例，假无 肌层浸润2例，诊断准确性、特异性、敏 感性分别为92.2%、90.4%和95.6%,均显著 高于常规MR方案的77.3%、75.9%/80.0%及 常规MR+DWI方案的83.6%、81.9%/86.7%， 差异具有统计学意义(P<0.05)。结论 将 常规MR平扫+DW-MRI扫描+DCE-MRI扫描方 案应用于膀胱癌患者T分期评估诊断中， 能有效提高诊断准确性及有效性，对节省 诊疗时间、改善诊疗效率、全面提升患者 预后水平等具有积极影响，值得临床推 广。

Objective To investigate the application value of different magnetic resonance imaging (MRI) sequence examinations in the evaluation and diagnosis of T staging of patients with bladder cancer. Methods 128 patients with bladder cancer confirmed by surgery and pathology who were treated in the hospital during May 2013 to October 2014 were selected as the research objects. The patients raceived different MRI sequence examinations. The surgical or pathological examination results were taken as the gold standard to evaluate the differences in specificity, sensitivity and accuracy of conventional MR scan, conventional MR scan with diffusion weighted imaging (DW-MRI) scan, conventional MR scan with DW-MRI scan and dynamic contrast enhanced (DCEMRI) scan of three kinds of MRI sequence examinations in the diagnosis of T staging of patients with bladder cancer. Results Among the 128 cases of patients with bladder cancer who received surgical or pathological examination, there were 83 cases (64.8%) diagnosed as without bladder wall muscular layer invasion and 45 cases (35.2%) with bladder wall muscular layer invasion . 43 cases with muscular layer invasion were correctly diagnosed by routine MR with DWI and DCE-MRI. 75 cases without muscular layer invasion were diagnosed correctly, including 8 cases with false muscular layer invasion and 2 cases without. The diagnostic accuracy, specificity and sensitivity were 92.2%, 90.4% and 83.6%, respectively, which were significantly higher than 77.3%, 75.9%, 80.0% of conventional MR and 83.6%, 81.9%, 86.7% of conventional MR with DWI (81.9%/86.7%), and the differences were statistically significant (P<0.05). Conclusion To apply conventional MR scan with DW-MRI scan and DCE-MRI in the evaluation and diagnosis of T staging of patients with bladder cancer can effectively improve the diagnostic accuracy and effectiveness, which has positive effect on saving consultation hours, improving the efficiency of diagnosis and treatment and comprehensively improving the prognosis of patients. It is worthy of clinical promotion.