The Role of Diffusion Weighted Magnetic Resonant Imaging in The Diagnosis of Malignant and Benign Urinary Bladder Lesions

Abstract

Objective: To determine the diagnostic accuracy of Diffusion Weighted MRI for detection of Malignant Urinary Bladder lesions in patients presenting with hematuria by taking Histopathology as gold standard. Study Design: Cross-sectional (validation) study. Settings: Radiology department of Allied Hospital Faisalabad Duration: from 10th February, 2015 to10th February, 2016. Methodology:  128 patients of both sexes with age from 20 to 70 years presenting with hematuria and bladder mass on ultrasonograph were included by using non probability consecutive sampling. Patients with history of metallic implants, known pregnant females and claustrophobic patients were excluded. Pelvic examination was performed using 1.5Tesla ACHIEVA PHILIPS with a sense body-4 coil. The gradient power of superconducting magnet is 30mT/m. FOV 350cm. Cystoscopic biopsy was performed in the Urology Department of Allied Hospital by consultant urologist and specimen was sent to pathology laboratory of Punjab Medical College for histopathology. Results: In this study, 38(29.69%) were between 20-50 years of age while 90(70.31%) were between 51-70 years of age, average mean of age was 55.62±6.91 years. 97(75.78%) were male and 31(24.22%) were females. Malignant urinary bladder lesions were recorded positive in 91(71.09%). Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate of diffusion weighted MRI for detection of malignant urinary bladder lesions in patients presenting with hematuria were recorded as 85.71%, 81.08%, 91.76%, 69.77% and 84.38% respectively. Conclusion: DWI may be beneficial in the differentiation of benign and malignant urinary bladder lesions, as well as of high-grade and low-grade urinary bladder carcinomas.