使用多向高 b 值扩散加权成像 (MDHB-DWI) 的定量参数预测膀胱尿路上皮癌 (UCB) 的肌肉侵犯状态，并将这些参数与膀胱成像报告和数据系统 (VI-RADS) 进行比较）。在这项前瞻性研究中，2023年5月至2024年5月期间入组经病理证实的UCB患者。所有参与者均接受术前MRI检查，包括MDHB-DWI和常规MRI。 MDHB-DWI（扩散峰度成像 [DKI]、扩散张量成像 [DTI]、平均表观传播器 [MAP] 和神经突定向色散和密度成像 [NODDI]）的平均定量参数值和表观扩散系数 (ADC) 值分别为使用 T 检验或秩和检验在非肌肉侵入性 (NMIBC) 和肌肉侵入性 (MIBC) 组之间进行比较。基于从 MDHB-DWI 获得的显着扩散参数，使用多元逻辑回归分析开发了定量 MRI 模型。绘制受试者工作特征（ROC）曲线，采用DeLong检验比较模型与VI-RADS的曲线下面积（AUC）。 共76例UCB患者（56名男性；NMIBC/MIBC= 51/25）包括在内。 DKI 的轴向扩散率 (AD) 和 DTI 的平均扩散率 (MD) 被确定为构建定量 MRI 模型的独立预测因子。该模型的 AUC 为 0.936，显着优于 VI-RADS (AUC=0.831) (p = 0.007)。MDHB-DWI 的 DKI-AD 和 DTI-MD 表现出区分 UCB 肌肉侵袭的强大能力。与 VI-RADS 相比，它们的组合显着提高了诊断效率。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

To predict the muscular invasion status of bladder urothelial carcinoma (UCB) using quantitative parameters from multi-directional high b-value diffusion-weighted imaging (MDHB-DWI), and compare these parameters with the Vesical Imaging Reporting and Data System (VI-RADS).In this prospective study, patients with pathologically confirmed UCB were enrolled between May 2023 and May 2024. All participants underwent preoperative MRI, including MDHB-DWI and conventional MRI. The average quantitative parameter values of MDHB-DWI (diffusion kurtosis imaging [DKI], diffusion tensor imaging [DTI], mean apparent propagator [MAP] and neurite orientation dispersion and density imaging [NODDI]) and apparent diffusion coefficient (ADC) values were compared between non-muscle invasive (NMIBC) and muscle-invasive (MIBC) groups using the T-test or rank sum test. Quantitative MRI models were developed using multivariate logistic regression analyses based on significant diffusion parameters obtained from MDHB-DWI. Receiver operating characteristic (ROC) curves were plotted, and DeLong's test was applied to compare the area under the curve (AUC) of the model with that of VI-RADS.A total of 76 patients with UCB (56 males; NMIBC/MIBC=51/25) were included. Axial diffusivity (AD) from DKI and mean diffusivity (MD) from DTI were identified as independent predictors for constructing a quantitative MRI model. The AUC of the model was 0.936, significantly outperforming VI-RADS (AUC=0.831) (p = 0.007).DKI-AD and DTI-MD from MDHB-DWI demonstrate a robust ability to differentiate muscular invasion in UCB. Their combination significantly improves diagnostic efficiency compared to VI-RADS.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.