NGHIÊN CỨU ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ GIÁ TRỊ CỘNG HƯỞNG TỪ TRONG CHẨN ĐOÁN GIAI ĐOẠN XÂM LẤN CỦA UNG THƯ BÀNG QUANG

Abstract

Background: The Vesical Imaging-Reporting and Data System - VI-RADS score on multiparametric magnetic resonance imaging plays an essential role in bladder cancer staging. Objectives: To describe the clinical characteristics and evaluate the diagnostic value of the VI-RADS score in bladder cancer staging. Materials and methods: A cross-sectional descriptive study was conducted on 90 patients with suspected bladder cancer who underwent multiparametric magnetic resonance imaging. Imaging findings were cross-referenced with histopathological results at Binh Dan Hospital from May 2025 to April 2026. Results: The mean patient age was 65.57 ± 11.45 years, with a male predominance of 88.9%. The most common symptom was hematuria, accounting for 88.8%. Histopathology revealed that solitary tumors comprised 65.2%, and transitional cell carcinoma accounted for 94.4%. The VI-RADS score demonstrated diagnostic value for muscle invasion, yielding an area under the curve - AUC ranging from 0.865 to 0.906; p < 0.001. A cutoff > 3 served as the optimal threshold for definitive diagnosis, with an AUC of 0.906, sensitivity of 87.5%, specificity of 93.7%, and accuracy of 91.6%. A cutoff > 2 achieved absolute screening efficacy, with both sensitivity and negative predictive value reaching 100%. Notably, the apparent diffusion coefficient demonstrated a good independent diagnostic value with an AUC of 0.765; p = 0.001, serving as a 'virtual biopsy' that effectively supports VI-RADS when histopathological specimens lack the muscle layer. Conclusions: The VI-RADS score is highly valuable in diagnosing muscle-invasive bladder cancer, and a cutoff > 2 provides optimal screening efficacy.