Dixon技术鉴别乏脂肪肾血管平滑肌脂肪瘤与肾癌的价值  

Dixon Technique in Differentiating Lack-fat Renal Angiomyolipoma and Renal Cell Carcinoma

作　　者：孙军[1] 邢伟[1] 陈杰[1] 范敏[2] 陈铜兵[3] 张丽君[1] 

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

出　　处：《中国医学影像学杂志》2013年第9期644-647,共4页Chinese Journal of Medical Imaging

基　　金：常州市卫生局重大科技项目(ZD201110);常州市第十八批科技计划(应用基础研究)项目(CJ20122019)

摘　　要：目的探讨Dixon技术在乏脂肪肾血管平滑肌脂肪瘤(RAML)与肾癌(RCC)鉴别诊断中的价值。资料与方法分析16例乏脂肪RAML与36例RCC的Dixon图像,测量同相位(IP)、反相位(OP)、纯脂肪(FO)及纯水(WO)图像上肿瘤信号强度,计算肿瘤信号强度指数(TSII)、肿瘤脂肪分数(TFF),分别对两种肿瘤的TSII、TFF行独立样本t检验及ROC曲线分析。结果以肿瘤OP较IP图信号下降及相应FO较WO图信号增高为依据诊断乏脂肪RAML的准确度、敏感度、特异度分别为82.69%、87.50%、80.56%。乏脂肪RAML与RCC之间的TSII、TFF差异均有统计学意义(t=8.638、11.179,P<0.05);利用TSII鉴别的ROC曲线下面积为0.944,诊断乏脂肪RAML的准确度、敏感度、特异度分别为86.54%、93.75%、83.33%;利用TFF鉴别的ROC曲线下面积为0.986,诊断乏脂肪RAML的准确度、敏感度、特异度分别为94.23%、93.75%、94.44%。结论 Dixon技术,特别是其定量分析,对鉴别乏脂肪RAML与RCC具有重要价值。Purpose To explore the value of Dixon technique in differentiating lack- tat renal angiomyolipoma （RAML） and renal cell carcinoma （RCC）. Materials and Methods Dixon images of 16 patients with lack-fat RAML and 36 patients with RCC were analyzed, signal intensity of the tumor on the in-phase （IP）, oppose-phase, iht-only （FO） and water-only （WO） images were measured, tumor signal intensity index （TSII） and tumor fat fraction （TFF） were calculated and compared, then receiver operating characteristic （ROC） curve was used to analyze. Results The accuracy, sensitivity and specificity lbr diagnosing lack-l＇at RAML were 82.69%, 87.50% and 80.56%, respectively when using tumor signal intensity drop in OP images compared with IP images, and the corresponding FO images show higher signal intensity than the WO images. There was significant statistical difference of both TSII and TFF between lack-fat RAML and RCC （t=8.638, 11.179, P〈0.05）： area under the ROC curve using TSII for identification was 0.944, the accuracy, sensitivity and specificity were 86.54%, 93.75% and 83.33%, respectively for diagnosing lack-fat RAML： area under the ROC curve using TFF for identification was 0.986, the accuracy, sensitivity and specificity were 94.23%, 93.75% and 94.44%, respectively for diagnosing lack-tht RAML. Conclusion Dixon technology, especially its capability of quantitative analysis, is significantly valuable to differentiate lack-fat RAML from RCC.

关 键 词：肾肿瘤 脂肪瘤 平滑肌瘤 磁共振成像 Dixon技术 诊断 鉴别 

分 类 号：R730.262[医药卫生—肿瘤] R737.11[医药卫生—临床医学]