الفهرس 
Anatomy of the Urinary BladderOnly 14 pages are availabe for public view
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Abstract
Bladder cancer is the second most common neoplasm of the urinary tract worldwide. It accounts for 6–8% of malignancy in men and 2-3% in women, with the highest incidence rates in North American and Europe, as well as areas with endemic schistosomiasis in Africa and the Middle East.
Management of urinary bladder cancer is determined primarily on the basis of distinguishing superficial tumors from invasive ones because the treatment options differ considerably. Therefore, preoperative imaging studies would play an important diagnostic role if they could be used to precisely differentiate between the two categories of bladder cancer.
Cystoscopy is the standard approach in the diagnosis and treatment of bladder tumors. However, cystoscopy is an invasive technique may require anesthesia, and may have various disadvantages such as being operator dependent and patient discomfort due to repeated Cystoscopy. Because of these disadvantages, there are ongoing studies for non-invasive and high sensitive methods. Accordingly, CT and MRI are frequently used to diagnose and follow bladder tumors.
For the radiological evaluation of the urinary bladder carcinoma, magnetic resonance imaging (MRI) is a valuable imaging modality due to high tissue contrast, no radiation exposure, multiplanar imaging capabilities, and the possibility of tissue characterization. Recently, diffusion-weighted MR imaging (DW-MRI) has emerged as a diagnostic technique in the evaluation of various abdominal lesions. DW-MRI has advantages such as short acquisition time and high contrast resolution between tumors and normal tissue.
In this study, 20 patients suspected to have bladder cancer were scheduled for MR imaging. All patients were scheduled for different MR sequences including T2WIs, DWIs and post contrast T1WIs. Regarding the detection of urinary bladder carcinoma the sensitivity, specificity, and accuracy for differentiating superficial from invasive tumors using T2 images alone and combined use of T2 and DW images were 62.5%, 66.7%, 63.2% and 100%, 100%, 100% respectively. The sensitivity, specificity, and accuracy for differentiating superficial from invasive tumors using post contrast MR images alone and combined use of post contrast MR images and DW images were 92.3%, 100%, 93.3% and 100%, 100%, 100% respectively.
In addition, we concluded that there is inverse relationship between the mean ADC values and the histological grade of the tumor.
In conclusion, we assume that DW-MRI is a safe and confident method in detection and local staging of urinary bladder carcinoma. In addition, DW images may predict the histological grade of the tumor. Hence DWI may be added to routine imaging protocols of urinary bladder tumors.