化学位移成像定量分析鉴别乏脂肪肾血管平滑肌脂肪瘤与肾透明细胞癌  

Quantitative analysis of chemical shift imaging in the differentiation of renal angiomyolipoma with minimal fat from clear cell renal cell carcinoma

作　　者：孙军[1] 邢伟[1] 陈杰[1] 陈铜兵[2] 曹赘杰[3] 邢士军[1] 沈楠[1] 

机构地区：[1]苏州大学附属第三医院放射科 [2]苏州大学附属第三医院病理科 [3]苏州大学附属第三医院泌尿外科,江苏常州213003

出　　处：《实用放射学杂志》2013年第6期950-953,共4页Journal of Practical Radiology

基　　金：常州市卫生局重大科技项目（ZD201110）.

摘　　要：目的评价3．0T磁共振化学位移成像（CSI）定量分析在乏脂肪肾血管平滑肌脂肪瘤（RAMＬ）与肾透明细胞癌（RCCC）鉴别诊断中的价值。方法回顾性分析经病理证实的17例乏脂肪RAMI。与32例RCCC的CSI图像．测量同、反相位图像上肿瘤及参照组织脾脏、竖脊肌的信号强度，计算肿瘤信号强度指数（SII）、肿瘤脾脏信号比（TSR）及肿瘤-肌肉信号比（TMR），分别对2类肿瘤的SII、TSR及ＴMR进行独赢样本，检验，并应用接收者工作特征（ROC）曲线分析诊断两者的敏感性与特异性。结果乏脂肪RAMl．与RCCC之间的SII、TSR、TMR均存在显著统计学差异（t=12．577、-5．297、-5．402．P=0．000）；利用SII进行鉴别的ROC曲线下耐积为0．987。最佳鉴别闽值为18．23％，敏感性为94．1％．特异性为93．7％；利用TSR进行鉴别的曲线下面积为0．885．最佳鉴别阈值为-12．58％．敏感性为88．2％。特异性为81．2％；利用TMR进行鉴别的曲线下面积为0．879。最佳鉴别阈值为-l1．62％。敏感性为82．4％，特异性为78．1％。结论CSI定量分析对乏脂肪RAMI．与RCCC的鉴别诊断具有重要价值。Objective To evaluate the value of quantitative analysis of chemical shift imaging（CSl） in differential diagnosis of re- nal angiomyolipoma（ RAML} with minimal fat from renal clear cell carcinoma（RCCC） at 3.0 T MR. Methods The CS] images of 17 cases with pathologically proved RAML with minimal fat （Group 1） and 32 cases with pathologically confirmed RCCC [Group 2） were analyzed retrospeelively. Signal intensity of tumor, spleen, and erector spinae were measured on in-phase and out-phase ima- ges, respectively. Three parameters, including signal intensity index（SII）, tumor to spleen ratio（TSR） and tumor to muscle ratio （TMR） were calculated. These parameters were compared between two groups by Student＇s t-test respectively. The ROC curves were performed to evaluate the sensitivity and specificity of these parameters in differentiation between two groups respectively. Re- sults There were significant differences in SII, TSR and TMR between two groups respectively （t=12. 577, -5. 297, -5. 402, P=0. 000）. The area under curve（AUC） of ROC for SII was 0. 987, and the sensitivity and specificity were 94.1% and 93.7% re- spectively when the optimal threshold was 18.23%. The AUC for TSR was 0. 885, and the sensitivity and specificity were 88.2% and 81.2% respectively when the optimal threshold was -12.58%. The AUC for TMR was 0. 879, and the sensitivity and specific- ity were 82.4 % and 78. 1% respectively when the optimal threshold was- 11.62%. Conclusion The quantitative analysis of CSI plays an important role in differential diagnosis of RAML with minimal fat from RCCC.

关 键 词：磁共振成像 化学位移 肾脏 血管平滑肌脂肪瘤 透明细胞癌 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]