Objective:

To investigate the role of transrectal ultrasound (TRUS) and transrectal contrast-enhanced ultrasound (TR-CEUS) in diagnosing non-muscle-invasive bladder cancer (NMIBC) and make comparison with tran

sabdominal ultrasound (TAUS).

Methods:

This was a retrospective study and the hospitalized patients suspicious for bladder lesions between December 2019 and February 2021 were enrolled. Before the transurethral resection surgery

ultrasound examinations including TAUS

TRUS

and TR- CEUS were performed. The cystoscopy examination and pathological results after surgical resection were taken as gold standard.

Results:

According to the inclusion criteria

a total of 65 lesions from 43 patients were finally enrolled

including 44 malignant lesions (stage T

a

-T

1

bladder cancer) and 21 benign lesions. The maximum diameter of lesions between benign and malignant groups was not statistically different［5(5

13) mm

vs

8(5

12) mm］. TRUS detected more NMIBC than TAUS (90.9%

vs

68.2%

P

=0.008)

especially for the lesions in diameter 5 mm (

P

=0.008). In comparison with TAUS

TRUS detected more NMIBC on the triangle area

lateral wall

and base wall of the bladder (

P

=0.010). TR-CEUS improved the accuracy of identifying the boundary between lesion and muscle layer in contrast with TRUS (92.7%

vs

60.0%

P

=0.001). The sensitivity

specificity and accuracy of the TRUS combining TR-CEUS in diagnosis of NMIBC were separately 90.9%

90.5% and 90.8%.

Conclusion:

TRUS is useful for the detection of malignant lesions on triangle area

lateral wall and base wall of the bladder

and the lesions 5 mm. Combining TRUS with TR-CEUS could further enhance the differential diagnosis and staging assessment of NMIBC.