肾脏透明细胞癌扩散张量成像参数与组织病理的相关性  

Correlation of diffusion tensor imaging parameters and histopathology in the evaluation of renal clear cell carcinoma

作　　者：冯强[1] 马智军[1] 房伟[1] 董海霞[1] 高言君[1] 伍建林[3] 宗佩君[2] 张万伟[1] 

机构地区：[1]潍坊医学院附属益都中心医院CT—MR室,青州262500 [2]潍坊医学院附属益都中心医院病理科,青州262500 [3]大连大学附属中山医院放射科

出　　处：《中华放射学杂志》2015年第10期750-753,共4页Chinese Journal of Radiology

摘　　要：目的探讨肾脏透明细胞癌患者扩散张量成像（DTI）参数与组织病理的相关性。方法回顾性分析经手术病理证实为肾脏透明细胞癌且病变最大径≥1cm的30例患者。患者均行肾脏DTI检查，测量肾肿瘤和正常肾实质的ADC值、主特征向量（E1）值和各向异性分数（FA）值。对手术取得的病变组织行病理检查，将患者分为低级别（I～Ⅱ级）和高级别（Ⅲ～Ⅳ级）肾透明细胞癌组，并测得肿瘤细胞密度和微血管密度（MVD）。采用独立样本t检验比较高、低级别肾透明细胞癌的细胞密度和MVD，采用单因素方差分析比较正常。肾组织、高级别肾透明细胞癌、低级别肾透明细胞癌的DTI参数，采用Pearson相关检验分析各DTI参数与细胞密度和MVD的相关性。结果低级别组肾透明细胞癌15例（I级7例、Ⅱ级8例），高级别组肾透明细胞癌15例（Ⅲ级9例、Ⅳ级6例）。低、高级别组的肿瘤细胞密度分别为（51．73±6．73）％和（64．87±9．08）％，低、高级别肿瘤的MVD分别为（49．33±7．76）、（61．27±8．45）条，高倍视野，差异均有统计学意义（f值分别为-4．50和-4．03，P均〈0．05）。正常肾实质、低级别肾透明细胞癌和高级别肾透明细胞癌的ADC值分别为（2．08±0．10）×10-3、（1．24±0．19）×10-3、（1．08±0．19）×10-3mm2／s，E1值分另0为（2．19±0．15）×10-3、（1．44±0．16）×10-3、（1．21±0．21）×10-3mm2／s，FA分别为0．32±0．05、0．29±0．08、0．22±0．06，不同组织间上述值差异均有统计学意义（F值分别为148．347、127．366、11．511，JP均〈0．05）。ADC、E1、FA值与细胞密度间均呈负相关（r值分别为～0．796、～0．865、-0．730，P均〈0．05）；ADC、E1、FA值与MVD问均呈负相关（r值分别为-0．739、-0．826、-0．761，P均〈0．05）。结论DTI参数和肾透明细胞的病理分级间具有相关性。Objective To investigate the correlation between the diffusion tensor imaging （DTI） parameters and histopathology in renal clear cell carcinoma patients.Methods Thirty renal clear cell carcinoma patients with lesions more than 1 cm in diameter were retrospectively analyzed.All patients had DTI and apparent diffusion coefficient （ADC）,eigenvector l（E1）,fractional anisotropy（FA） value in normal kidney and lesion were measured respectively.The lesions were analyzed according to the Fuhrman nuclear grade for pathological findings.They were divided into two groups, namely high （ Ⅲ -Ⅳ）and low （ Ⅰ - Ⅱ ） grade groups. In addition, the cell density,micro-vessel density （MVD） of turmor were also measured.The differences between two groups in cell density,micro-vessel density were analyzed by independent samples t test, the difference among normal kidney,high and low grade groups of clear cell renal cell carcinoma were compared using ANOVA.The correlationsamong ADC,E1,FA value and cell density, micro-vessel density were analyzed using Pearson analysis. Results Fifteen cases of renal clear cell carcinoma were of low grade （level I ,8 cases, level ]1,7 cases）, 15 cases were of high grade （level m ,9 cases, level IV,6 cases）. The cell density of low and high grade tumors were （51.73±6.73）%, and （64.87±9.08）% respectively, the microvessel density were （49.33±7.76）/HP, and （61.27±8.45）/HP respectively. There were significant differences found（t= - 4.50, - 4.03, P〈0.05）. The ADC of normal renal tissues and low, high grade renal clear cell carcinoma were （2.08±0.10）× 10-3, （1.24±0.19）× 10-3, （1.08±0.19）× 10-3 mm2/s respectively, the E1 value were （2.19± 0.15）× 10-3, （1.44±0.16）× 10-3,（1.21 ±0.21）× 10-3mm2/s,respectively, and the FA were 0.32±0.05, 0.29±0.08, 0.22 ±0.06, respectively. There were significant differences in ADC,E1,FA values （F=148.347,127.366, 11.511,P〈0.05）. Cell density was negatively correlated to ADC

关 键 词：肾肿瘤 磁共振成像 病理学 

分 类 号：R737.11[医药卫生—肿瘤]