常见肾细胞癌体素内非相干运动成像的临床应用  

Study of intravoxel incoherent motion imaging in common renal cell carcinoma

作　　者：楚坤义 郑园园[1] 张辉[2] 冯平勇[3] 贺艾 邹语嫣 左玉强[4] 

机构地区：[1]邯郸市中心医院CT/MRI室,河北邯郸056001 [2]邯郸市中心医院放化疗二科,河北邯郸056001 [3]河北医科大学第二医院影像科,河北石家庄050000 [4]石家庄市第一医院放射二科,河北石家庄050011

出　　处：《临床荟萃》2016年第5期559-562,565,共5页Clinical Focus

基　　金：2014年度河北省医学科学研究重点课题计划(2D20140117)

摘　　要：目的应用磁共振扩散加权成像(DWI)中体素内非相干运动(intravoxel incoherent motion,IVIM)模型分析常见肾细胞癌(renal cell carcinoma,RCC)的影像特征,为指导临床个体化治疗提供更有价值的影像依据。方法回顾性分析行3.0T MRI多b值DWI检查且经外科病理证实的49例RCC患者,比较常见RCC亚型的表现扩散系数(ADC)值和IVIM各参数值的差异。结果透明细胞型肾细胞癌(clear cell RCC,ccRCC)和嫌色性肾细胞癌(chromophobe RCC,chRCC)的ADC值、假扩散系数(D*)值、灌注分数(f)值与乳头状肾细胞癌(papillary RCC,pRCC)比较差异均有统计学意义(P<0.05),其组织扩散系数(D)值差异均无统计学意义;ccRCC和chRCC的相关各参数值差异均无统计学意义(P>0.05)。结论ccRCC和chRCC都是富血供病变,其实性部分的ADC值及IVIM各参数值异无统计学意义;pRCC的ADC值、D*值和f值均低于ccRCC和chRCC;常见3种RCCs的D值差异无统计学意义。Objective To use intravoxel incoherent motion（IVIM）diffusion-weighted imaging of renal cell carcinoma（RCC）for comparing their imaging difference,so as to provide more valuable imaging basis for guiding clinical individualized treatment.Methods A retrospective study was made in 49 patients with RCC demonstrated by surgical pathology and imaged at 3.0T MRI using 8bvalues for diffusion-weighted imaging,the values of ADC and IVIM parameters were compared between different subtypes of RCC.Results The values of ADC,pseudodiffusivity coefficient（D＊）and perfusion fraction（f）of clear cell RCC（ccRCC）or chromophobe RCC（chRCC）compared with papillary RCC（pRCC）had statistically significant difference（P 0.05）,but the value of tissue diffusivity（D）demonstrated no significant difference.Conclusion ccRCC and chRCC are hypervascular tumors,the values of ADC and IVIM parameters were no significant difference in the solid portion between ccRCC and chRCC.The values of ADC,D＊and f were lower in pRCC than those of ccRCC and chRCC.The value of D demonstrates no significant difference between common subtypes of RCC.

关 键 词：肾肿瘤 磁共振成像 

分 类 号：R737.11[医药卫生—肿瘤]