扩散加权成像ADC值在肾细胞癌与肾错构瘤中的临床应用  

Apparent diffusion coefficient value of diffusion-weighted magnetic resonance imaging in the diagnosis and differential diagnosis between renal cell carcinoma and angiomyolipoma of kidney

作　　者：马普能[1] 李伟[1] 申杰[1] 吴昆华[2] 章卓睿[1] 杨敏[1] 邹岷[1] 张德清[1] 雷云[2] 杨桦[1] 

机构地区：[1]云南省第一人民医院泌尿外科,昆明650032 [2]云南省第一人民医院核磁共振科

出　　处：《临床泌尿外科杂志》2015年第6期495-497,501,共4页Journal of Clinical Urology

基　　金：云南省卫生厅内设研究机构(云南省泌尿系微创生殖研究中心)研究项目(编号2014NS252)

摘　　要：目的：探讨扩散加权成像表观弥散系数（ADC）值在肾细胞癌与肾错构瘤临床诊断及鉴别诊断中的应用价值。方法：以术后病检结果作为诊断金标准,以与肿瘤相对应的健侧肾实质的ADC值作为对照,对2012年4月～2014年4月我院收治并手术治疗的73例肾脏肿瘤患者的1.5T核磁共振扩散加权成像检查结果进行回顾性分析。其中肾细胞癌55例,肾错构瘤18例;核磁共振扩散加权成像b值取1 500s/mm^2。结果：肾细胞癌组织、肾错构瘤组织、正常肾实质组织ADC值分别为（1.13±0.14）×10^-3 mm^2/s、（0.63±0.11）×10^-3 mm^2/s、（2.31±0.12）×10^-3 mm^2/s。肾细胞癌、肾错构瘤与正常肾实质相比,ADC值有下降趋势,且肾错构瘤组织ADC值下降明显。肾错构瘤组织ADC值显著低于肾细胞癌组织ADC值,差异有统计学意义﹙t=7.26,P〈0.05﹚。结论：核磁共振扩散加权成像ADC值是一项更加客观、直接、有效的影像学指标,在肾细胞癌与肾错构瘤的临床诊断及鉴别诊断中具有重要的应用价值;同时,核磁共振扩散加权成像应当作为肾细胞癌早期诊断与鉴别诊断的常规检查之一。Objective：To investigate the apparent diffusion coefficient（ADC）value of diffusion-weighted magnetic resonance imaging（DWI-MRI）in diagnosing and differentiating between renal cell carcinoma and angiomyolipoma of kidney.Method：From April 2012 to April 2014,73 patients were diagnosed with renal neoplasm and treated with surgical procedure in our hospital.All of these patients underwent 1.5T DWI-MRI before operation and the results were analyzed retrospectively.Taking the pathological examination of surgical specimens as the golden standard of diagnosis,55 patients were diagnosed with renal cell carcinoma and 18 patients were diagnosed with angiomyolipoma of kidney.DWI-MRI were obtained with b value of 0and 1 500s/mm^2.Result：The ADC value of renal cell carcinoma,angiomyolipoma of kidney and normal renal parenchyma were（1.13±0.14）×10^-3mm^2/s,（0.63±0.11）×10^-3 mm^2/s,and（2.31±0.12）× 10-3 mm^2/s respectively.Comparing with the normal renal parenchyma,the ADC value of renal cell carcinoma and angiomyolipoma of kidney showed a downtrend,and the downtrend of the ADC value of angiomyolipoma of kidney was more significant.Differences of the ADC value between angiomyolipoma of kidney and renal cell carcinoma showed statistically significant（t=7.26,P〈0.05）.Conclusion：The ADC value of DWI-MRI is a kind of objective,direct and effective indicator.It plays an important role in diagnosing and differentiating between renal cell carcinoma and angiomyolipoma of kidney.Moreover,DWI-MRI should be taken as one of the routine inspection in the early diagnosis and differential diagnosis of renal cell carcinoma.

关 键 词：核磁共振 扩散加权 表观弥散系数值 肾细胞癌 肾错构瘤 

分 类 号：R737.11[医药卫生—肿瘤]