Figure 12.

Urothelial carcinoma (stage T2) in an 80-year-old man. Axial (A) and coronal (B) T2-weighted images showing an intermediate signal intensity ovoid-shaped mass (arrow) in the bladder dome. A high b value axial diffusion-weighted magnetic resonance image (C) and apparent diffusion coefficient map (D) showing marked diffusion restriction of the whole tumor area. There is no clear disruption of the low signal intensity muscle layer. However, category 2 findings are lacking on T2-weighted images and diffusion-weighted images. Axial (E) and coronal (F) three-dimensional T1-weighted spoiled gradient echo image obtained 180 seconds after contrast agent administration also show contrast-enhanced category 3. This case should be scored as vesicle imaging-reporting and data system grade 3. The patient underwent transurethral resection of the bladder tumor. Appropriate tumor specimens with muscle tissue were examined and the patient was diagnosed with high-grade stage T2 cancer.