Quantitative MRI in distinguishing bladder paraganglioma from bladder leiomyoma

Abstract

Purpose: To investigate the feasibility of quantitative MRI in the differentiation of bladder paraganglioma from bladder leiomyoma.

Methods: From 2014 to 2021, 11 patients with bladder paraganglioma and 14 patients with bladder leiomyoma confirmed by surgical pathology were retrospectively collected. All patients underwent multiparametric scanning with a 3.0 T MR system. Quantitative parameters including the SI-ratio on T₁WI between the solid component of tumours and piriformis, ADC value and E-rate of the solid component of tumours were assessed. Independent sample t test or Mann-Whitney U test was used to compare these parameters between the two groups. The diagnostic efficiency of the parameters was examined using ROC curve analysis and the DeLong test.

Results: There were significant differences in SI-ratio on T₁WI (P < 0.001), ADC value (P = 0.002) and the E-rate (P = 0.040) between the paraganglioma group and the leiomyoma group. The cutoff value of SI-ratio on 3 leiomyoma was 1.241, and the AUC was 1.000 (0.858-1.000). The cutoff value of the ADC value was 0.979 × 10^-3mm²/s, and the AUC was 0.907 (0.717-0.987). The cutoff value of E-rate was 98.7%, and the AUC was 0.714 (0.495-0.878). The AUCs of the SI-ratio on T₁WI and ADC value were significantly higher than the E-rate AUC (P = 0.015 and 0.034, respectively).

Conclusion: Quantitative MRI can effectively distinguish bladder paraganglioma from bladder leiomyoma with the SI-ratio on T₁WI or ADC value.

Keywords: Bladder Leiomyoma; Bladder Paraganglioma; Magnetic resonance imaging (MRI); Quantitative parameter.