Comparison of Contrast-Enhanced Ultrasound and Enhanced Magnetic Resonance Imaging in Assessing the Depth of Invasion in Bladder Urothelial Carcinoma

INTRODUCTION: Accurate assessment of muscularis propria invasion is critical for therapeutic decision-making in bladder cancer. The application of contrast-enhanced ultrasound (CEUS) in bladder cancer requires further validation. METHODS: Using histopathology as the reference standard, we compared the diagnostic performance of CEUS and enhanced magnetic resonance imaging (E-MRI) in 190 patients who underwent transurethral resection of bladder tumor. The accuracy, sensitivity, and specificity of both modalities in determining malignancy and muscular invasion were analyzed. RESULTS: For diagnosing malignant tumors, the accuracy of CEUS and E-MRI was 83.87% and 80.64%, respectively. No significant differences were observed in sensitivity (85.71% vs. 84.28%) or specificity (78.26% vs. 69.56%) (p > 0.05). In assessing muscular invasion, CEUS demonstrated significantly higher specificity than E-MRI (95% vs. 77.5%, p = 0.039), while no significant difference was found in sensitivity (77.33% vs. 74.66%). CONCLUSION: CEUS exhibits superior specificity for evaluating muscular invasion in bladder urothelial carcinoma and can serve as a valuable complement to E-MRI for clinical staging.