1.Value of VI-RADS scoring combined with tumor quantitative MRI parameters in assessing muscle invasion of bladder cancer
Haili LIU ; Yijian CHEN ; Yuanhao MA ; Jian ZHAO ; Huiping GUO ; Xiaohui DING ; Guijuan ZHAI ; Fei YAN ; Wei XU ; Tianran LI ; Haiyi WANG
Chinese Journal of Radiology 2025;59(5):558-564
Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.
2.Value of VI-RADS scoring combined with tumor quantitative MRI parameters in assessing muscle invasion of bladder cancer
Haili LIU ; Yijian CHEN ; Yuanhao MA ; Jian ZHAO ; Huiping GUO ; Xiaohui DING ; Guijuan ZHAI ; Fei YAN ; Wei XU ; Tianran LI ; Haiyi WANG
Chinese Journal of Radiology 2025;59(5):558-564
Objective:To explore the value of the vesical imaging-reporting and data system (VI-RADS) score based on multiparametric MRI (mpMRI) combined with quantitative tumor MRI parameters in assessing the muscle invasion of bladder cancer.Methods:The study was a case-control study. The data of 87 bladder cancer patients confirmed by pathology who underwent mpMRI of the bladder were retrospectively collected from the First Medical Center of Chinese PLA General Hospital between January 2019 and April 2023 The pathological findings were used as the gold standard to categorize them into the muscle invasive bladder cancer (MIBC) group (29 cases) and non-muscle invasive bladder cancer (NMIBC) group (58 cases). Quantitative parameters were measured based on preoperative mpMRI images, including the length of tumor bladder wall contact, the perpendicular distance between the bladder tumor and the tangent of the bladder wall, the maximal diameter of the bladder tumor, and the volume of the bladder tumor. Bladder cancer was classified according to the VI-RADS scoring criteria. The Mann-Whitney U test was used for intergroup comparisons. Multivariate logistic regression analysis was performed to obtain the independent risk factors related to muscle invasion of bladder cancer and to establish the model. The receiver operating characteristic curves were analyzed for MRI quantitative parameters and logistic regression models, and area under the curve (AUC) comparisons were performed using the DeLong test. Results:The differences in tumor bladder wall contact length, perpendicular distance from the tumor to the tangent line of the bladder wall, maximum diameter, bladder tumor volume, and the VI-RADS scores were statistically significant between the MIBC group and the NMIBC group ( P<0.05). Multifactorial logistic regression analysis showed that tumor bladder wall contact length ( OR=21.07, 95% CI 3.56-124.89, P=0.001) and VI-RADS score ( OR=11.90, 95% CI 3.53-40.12, P<0.001) were the independent risk factors for evaluating the muscle invasion of bladder cancer. The difference between the VI-RADS score and the tumor bladder wall contact length for assessing muscular infiltration of bladder cancer had AUCs of 0.802 (95% CI 0.704-0.899) and 0.759 (95% CI 0.652-0.865). The combined model of VI-RADS score combined with tumor bladder wall contact length had an AUC of 0.891 (95% CI 0.812-0.970), which was higher than the diagnostic efficacy of applying tumor bladder wall contact length or VI-RADS score alone ( Z=3.05, 2.37, P=0.002, 0.018). Conclusion:Tumor contact length with the bladder wall is an independent risk factor for assessing muscle invasion of bladder cancer and the combination of VI-RADS score may enhances diagnostic accuracy.
3.Comparison of the Effects of Qili Qiangxin Capsules and Compound Danshen Drop Pills on Related Index-es of AMI Patients without Reflow after PCI
Chun YU ; Zhongyan LI ; Donghui YU ; Guijuan ZHAI
China Pharmacy 2017;28(18):2473-2476
OBJECTIVE:To compare the effects of Qili qiangxin capsules and Compound danshen drop pills on related indexes of acute myocardial infarction(AMI)patients without reflow after percutaneous coronary intervention(PCI). METHODS:A total of 90 AMI patients without reflow after PCI were randomly divided into Compound danshen drop pills group (45 cases) and Qili qiangxin capsules group(45 case). Both groups were given Aspirin chewable tablets 300 mg and Clopidogrel sulfate tablets 300 mg before PCI. After surgery,both groups were given Aspirin chewable tablets 100 mg,once a day+simvastatin chewable tablets 10 mg,once a day. Based on it,Compound danshen drop pills group was given Compound danshen drop pills,10 pills,3 times a day. Qili qiangxin capsules group was given Qili qiangxin capsules,4 capsules,3 times a day. Both groups were treated for consec-utive 6 months. The blood flow classification of TIMI,LEVF,β1-AR,β2-AR,α1-AR,bleeding and the occurrence of major cardio-vascular events were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:Bafore treatment,there was no statistical significance in the blood flow classification of TIMI,the levels of β1-AR,β2-AR and α1-AR be-tween 2 groups(P>0.05). After treatment,the case number of 0-2 degree blood flow classification of TIMI in 2 groups were signif-icantly lower than before treatment while the case number of 3 degree were significantly higer than before treatment;the levels ofβ1-AR,β2-AR and α1-AR were significantly lower than before treatment,while LEVF was significantly higher than before treatment;LEVF of Qili qiangxin capsules group was significantly higher than that of Compound danshen drop pills group,with statistical signifi-cance (P<0.05). There was statistical significance in the incidence of bleeding and major cardiovascular events between 2 groups (P>0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Qili qiangxin capsules is similar to Com-pound danshen drop pills in improving no-reflow efficacy and safety of AMI patients after PCI,but it is better than Compound dan-shen drop pill in improving cardiac function.

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