李香音,张玉英

本文主要是讨论常规超声和超声造影在膀胱癌分级和分期中的运用现状及诊断价值。膀胱癌是泌尿系统中最常见的恶性肿瘤，术前对其进行准确的分期和分级是治疗膀胱癌的关键环节。超声技术作为一种无创性诊断手段，在膀胱癌的分期和分级过程中具有显著的临床价值。B超、SWE及CEUS等不同类型的超声影像能够呈现不同级别肿瘤的独特表现。因此，医生可以结合常规超声与超声造影图像全面评估肿瘤的分期和分级，从而指导膀胱癌的临床治疗，降低过度治疗和重复治疗的风险。此外，超声技术还可作为膀胱癌治疗后的首选复查方法。

膀胱肿瘤；超声造影；剪切波弹性成像；VI-RADS评分系统

[1] Richters, A., Aben, K.K.H. & Kiemeney, L.A.L.M. The global burden of urinary bladder cancer: an update. World J Urol 38, 1895-1904 (2020). [2] Freddie,Bray,Jacques,et al.Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.[J].CA: a cancer journal for clinicians, 2018,68(6):394-424. [3] 陈松丽. 基于超声影像组学预测膀胱肿瘤病理分级的临床研究[D].南昌大学,2023. [4] Zhu S and Zhao H (2024) Sexual dimorphism in bladder cancer: a review of etiology, biology, diagnosis, and outcomes. Front. Pharmacol. 14:1326627,2023. [5] Yang Y, Wang C, Li Z, Lu Q and Li Y (2023) Precise diagnosis and treatment of non-muscle invasive bladder cancer - A clinical perspective. Front. Oncol. 13:1042552,2023. [6] Yang, H.-Y.; Wu, C.-Y.; Chen, J.-J.; Lee, T.-H. Treatment Strategies and Metabolic Pathway Regulation in Urothelial Cell Carcinoma: A Comprehensive Review. Int. J. Mol. Sci. 2020, 21, 8993. [7] Vanarsa,K.,Castillo,J.,Wang,L.etal.Comprehensive proteomics and platform validation of urinary biomarkers for bladder cancer diagnosis and staging.BMC Med21, 133 (2023). [8] 吴月,陈松丽,赵静,等.膀胱肿瘤与膀胱壁接触长度及角度预测肌层浸润性膀胱癌的价值[J].中国超声医学杂志, 2023,39(02):201-204. [9] 郭素萍,周爱云,徐盼,等.常规超声联合超声造影鉴别膀胱内翻性乳头状瘤与膀胱尿路上皮癌[J].中国超声医学杂志, 2017,33(01):54-56. [10] 吴丹,项俊,苏昊博,等.经腔内与经腹式超声对膀胱癌分期的诊断价值[J].中国肿瘤临床与康复,2019,26(09):1081-1083. [11] 黄丽燕,柯丽明,陈志奎,等.超声鉴别诊断膀胱内翻性乳头状瘤与膀胱移行细胞癌[J].中国医学影像技术,2015,31(06):910-912. [12] 朱峰,徐卫华,周敏,等.二维超声联合剪切波弹性成像技术在膀胱尿路上皮癌中的应用研究[J].中国临床医学影像杂志, 2021,32(03):203-205+211. [13] Stangierski, A., Wolinski, K. & Ruchala, M. Shear wave elastography in the diagnostics of parathyroid adenomas–new application of the method. Endocrine 60, 240–245 (2018). [14] Fu B, Zhang H, Song ZW, Lu JX, Wu SH and Li J: Value of shear wave elastography in the diagnosis and evaluation of cervical cancer. Oncol Lett 20: 2232-2238, 2020. [15] Zhang, Hp., Liang, Rx., Lin, Xy. et al. Application of contrast-enhanced ultrasound in diagnosis and grading of bladder urothelial carcinoma. BMC Med Imaging 24, 26 (2024). [16] Karahan O I , Yikilmaz A , Ekmekcioglu O ,et al.Color Doppler ultrasonography findings of bladder tumors: correlation with stage and histopathologic grade.[J].Acta Radiologica, 2004, 45(4):481. [17] Tufano, A.; Rosati, D.; Moriconi, M.; Santarelli, V.; Canale, V.; Salciccia, S.; Sciarra, A.; Franco, G.; Cantisani, V.; Di Pierro, G.B. Diagnostic Accuracy of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Muscle-Invasive Bladder Cancer: A Systematic Review and Diagnostic Meta-Analysis. Curr. Oncol. 2024, 31, 818-827. [18] Caruso G , Salvaggio G , Campisi A ,et al.Bladder tumor staging: comparison of contrast-enhanced and gray-scale ultrasound.[J].Ajr American Journal of Roentgenology, 2010, 194(1):151. [19] Saftoiu A, Gilja OH, Sidhu PS. et al.The EFSUMB Guidelines and Recommendations for the Clinical Practice of Elastography in Non-Hepatic Applications: Update 2018[J].Ultraschall in der Medizin, 2019,40(4):425-453. [20] 王琳,宣之东,张颖,等.尿路上皮癌的膀胱肿瘤三维超声造影特性与微血管密度相关性分析[J].中国超声医学杂志,2021, 37(08):910-913. [21] Canoğlu, A., Göğüş, Ç., Bedük, Y. et al. Microvessel density as a prognostic marker in bladder carcinoma: Correlation with tumor grade, stage and prognosis. Int Urol Nephrol 36, 401–405 (2004). [22] 李秋洋,唐杰,何恩辉,等.超声造影在鉴别膀胱上皮癌分级中的应用价值[J].中国医学科学院学报,2012,34(04):364-368. [23] 徐盼,周爱云,袁新春,等.超声造影时间-强度曲线鉴别高级别与低级别膀胱尿路上皮癌[J].中国医学影像技术,2015, 31(02):282-285. [24] 张力,董鑫,肖丹丹,等.多层螺旋CT增强扫描与超声造影在膀胱癌术前分期中的诊断价值[J].临床和实验医学杂志,2022, 21(01):97-99. [25] 朱琚.多模态超声在膀胱癌分级和分期中的应用价值[D].兰州大学,2023. [26] Shalaby, Essam A.a,∗; Mohamed, Ahmed R.b; Elkammash, Tarek H.b; Abouelkheir, Rasha T.c; Housseini, Ahmed M.b. Role of multiparametric magnetic resonance imaging in the diagnosis and staging of urinary bladder cancer. Current Urology 16(3):p 127-135, September 2022. [27] Panebianco V , Narumi Y , Altun E ,et al.Multiparametric Magnetic Resonance Imaging for Bladder Cancer:Development of VI-RADS (Vesical Imaging-Reporting And Data System),European Urology,2018,74(3):94-306. [28] 褚雨露.VI-RADS评分对膀胱癌肌层浸润的诊断价值研究[D].安徽医科大学,2023. [29] Luo C , Huang B , Wu Y ,et al.Use of Vesical Imaging-Reporting and Data System (VI-RADS) for detecting the muscle invasion of bladder cancer: a diagnostic meta-analysis[J].European Radiology, 2020,30(8):4606-4614. [30] Fu, W., Liu, D., Xiong, Y. et al. The comparison between contrast-enhanced ultrasound and contrast-enhanced magnetic resonance imaging in diagnosing bladder urothelial carcinoma. Int Urol Nephrol 55, 1073–1079 (2023).  [31] Woo S , Panebianco V , Narumi Y ,et al.Diagnostic Performance of Vesical Imaging Reporting and Data System for the Prediction of Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis[J].European Urology Oncology, 2020,3(3)306-315. [32] Li C , Gu Z , Ni P ,et al.The value of contrast-enhanced ultrasound and magnetic resonance imaging in the diagnosis of bladder cancer[J].Journal of cancer research and therapeutics, 2021, 17(5):1179-1185.

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