Role of MRI in detection and classification of types and grades of Urinary bladder Cancers
Tamer Abdelaziz Salem Elhiti;
Abstract
Urinary bladder carcinoma is the most common malignancy involving the urinary tract. Cigarette smoking and specific occupational exposures are the main known causes of UBC. Chronic infection by Schistosoma haematobium is a cause of squamous cell carcinoma of the bladder. Pre-neoplastic lesions of the urinary bladder including proliferative and metaplastic lesions, these changes have a significantly increased risk for the development of transitional cell carcinoma of the urinary bladder.
Cystoscopy and biopsy are the standard of reference for bladder evaluation, but imaging is important for accurate staging and treatment planning. In Plain Radiography the calcification of the wall of the bilharizial bladder usually appears as a continuous curved line of calcification and the neoplasm interrupts the continuity of the linear calcification. The traditional initial radiological investigation has been intravenous urography, a primary tumor may appear as a small-capacity, thick-walled bladder or as a focal mass. The utilization of ultrasonography as the initial radiological investigation for detection of bladder carcinomas in patients presenting with hematuria is recommended. Sonography is not routinely used for staging cancer of the urinary bladder; the tumor often appears as a polypoid or plaque like, hypoechoic lesion that may project into the bladder.
The major role of CT in bladder carcinoma is to stage rather than to detect the primary tumor. It is inaccurate for early stage. In the nephrographic phase, the enhancing tumor can be visualized against a background of low-attenuation urine within the bladder. On delayed scanning, the lesion appears as a mural nodule against a background of high-attenuation contrast material within the bladder.
Presently, MR imaging is the modality of choice in imaging urinary bladder neoplasms. MR urography can easily allow diagnosis of urinary tract dilatation and detect the level of obstructions with accuracy up to 100%.
On T1-weighted images, the bladder wall and urothelial tumor are intermediate in signal intensity yet, the tumor is intermediate in signal intensity on T2-weighted images. The stalk of papillary transitional cell carcinoma shows lower signal intensity than tumor on T2WI, less enhancement on dynamic images and stronger enhancement on delayed enhanced images.
Squamous cell carcinoma In contrast to urothelial carcinoma is sessile rather than papillary, and pure intraluminal growth is not seen. Multiplanar MR imaging can demonstrate the presence and precise location of the bladder diverticular neck. On T2-weighted images, focal areas of high signal intensity from mucin are highly suggestive of urachal carcinoma.
Typically, leiomyomas exhibit intermediate signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Rhabdomyosarcoma has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images with heterogeneous enhancement. Multiple grapelike intraluminal masses are highly suggestive of botryoid rhabdomyosarcoma. Low signal intensity on T1-
Cystoscopy and biopsy are the standard of reference for bladder evaluation, but imaging is important for accurate staging and treatment planning. In Plain Radiography the calcification of the wall of the bilharizial bladder usually appears as a continuous curved line of calcification and the neoplasm interrupts the continuity of the linear calcification. The traditional initial radiological investigation has been intravenous urography, a primary tumor may appear as a small-capacity, thick-walled bladder or as a focal mass. The utilization of ultrasonography as the initial radiological investigation for detection of bladder carcinomas in patients presenting with hematuria is recommended. Sonography is not routinely used for staging cancer of the urinary bladder; the tumor often appears as a polypoid or plaque like, hypoechoic lesion that may project into the bladder.
The major role of CT in bladder carcinoma is to stage rather than to detect the primary tumor. It is inaccurate for early stage. In the nephrographic phase, the enhancing tumor can be visualized against a background of low-attenuation urine within the bladder. On delayed scanning, the lesion appears as a mural nodule against a background of high-attenuation contrast material within the bladder.
Presently, MR imaging is the modality of choice in imaging urinary bladder neoplasms. MR urography can easily allow diagnosis of urinary tract dilatation and detect the level of obstructions with accuracy up to 100%.
On T1-weighted images, the bladder wall and urothelial tumor are intermediate in signal intensity yet, the tumor is intermediate in signal intensity on T2-weighted images. The stalk of papillary transitional cell carcinoma shows lower signal intensity than tumor on T2WI, less enhancement on dynamic images and stronger enhancement on delayed enhanced images.
Squamous cell carcinoma In contrast to urothelial carcinoma is sessile rather than papillary, and pure intraluminal growth is not seen. Multiplanar MR imaging can demonstrate the presence and precise location of the bladder diverticular neck. On T2-weighted images, focal areas of high signal intensity from mucin are highly suggestive of urachal carcinoma.
Typically, leiomyomas exhibit intermediate signal intensity on T1-weighted images and low signal intensity on T2-weighted images. Rhabdomyosarcoma has low signal intensity on T1-weighted images and high signal intensity on T2-weighted images with heterogeneous enhancement. Multiple grapelike intraluminal masses are highly suggestive of botryoid rhabdomyosarcoma. Low signal intensity on T1-
Other data
| Title | Role of MRI in detection and classification of types and grades of Urinary bladder Cancers | Other Titles | توطئة للحصول على الماجستير في الأشعة التشخيصية | Authors | Tamer Abdelaziz Salem Elhiti | Issue Date | 2014 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.