探讨磁共振扩散张量成像在肾脏实性肿瘤的应用价值  

To Discuss the Value of Diffusion Tensor Imaging in Solid Renal Tumors

作　　者：耿莉[1] 纵瑞龙[1] 黄周[1] 方向[1] 谢道海[1] 

机构地区：[1]苏州大学附属第一医院放射科,215006

出　　处：《临床放射学杂志》2017年第4期522-525,共4页Journal of Clinical Radiology

摘　　要：目的探讨扩散张量成像(DTI)在肾脏实性肿瘤中的诊断与鉴别诊断价值。方法 75例肾脏实性占位患者及30名健康志愿者纳入研究,所有受检者均行常规MRI及DTI扫描。将75例肿瘤分为血管平滑肌脂肪瘤、透明细胞癌、非透明细胞肾癌三类,测量观察指标各向异性分数(FA)、表观扩散系数(ADC)。两组之间计量资料比较采用独立样本t检验;以FA值、ADC值作为透明细胞癌和血管平滑肌脂肪瘤的评估效应值,构建ROC曲线进行诊断效能评价。结果肾血管平滑肌脂肪瘤ADC值低于正常肾皮质和髓质(P<0.05),FA值低于正常肾髓质(P<0.05)。透明细胞癌及非透明细胞癌FA值、ADC值均低于正常肾脏皮质和髓质(P<0.05)。血管平滑肌脂肪瘤与透明细胞癌、非透明细胞癌的FA值差异存在统计学意义(P<0.05),与透明细胞癌ADC值差异存在统计学意义(P<0.05)。透明细胞癌与非透明细胞癌ADC值差异具有统计学意义(P<0.05)。ADC值对诊断透明细胞癌准确性较高,以ADC值为评估值,临界值取1.380×10^(-3)mm^2/s,其敏感性为97.4%、特异性为66.7%。结论DTI对鉴别肾脏实性肿瘤的良恶性及推断恶性肿瘤病理类型具有一定价值。Objective To assess the diagnosis and differential diagnosis of diffusion tensor imaging（DTI） in solid renal tumor.Methods 75 cases of patients with solid renal lesions and 30 healthy volunteers were included in the study,all subjects underwent routine MRI scan and DTI scan.The 75 tumors were divided into angiomyolipoma,clear cell carcinoma,non-clear cell renal carcinoma.Fractional anisotropy（FA） and apparent diffusion coefficient（ADC） were measured.Measurement date between the two groups were compared using independent sample t test,P〈0.05 difference was statistically significant; The FA and ADC value was used as an evaluation of effect of clear cell carcinoma and angiomyolipoma.ROC curves were constructed to evaluate the effectiveness of diagnosis.t test,P〈0.05 difference was statistically significant; The FA、ADC value as an evaluation of effect of clear cell carcinoma and angiomyolipoma,building ROC curves for diagnosis effectiveness evaluation.Results The angiomyolipoma ADC value was below normal renal cortex and medulla（P〈0.05）,and FA value was below normal medulla（P〈0.05）.Clear cell carcinoma and non-clear renal cell carcinoma FA、ADC values were below normal renal cortex and medulla（P〈0.05）.FA value between angiomyolipoma and clear cell carcinoma,non-clear cell renal carcinoma were all statistically significant（P〈0.05）.ADC value between angiomyolipoma and clear cell carcinoma was statistically significant（P〈0.05）.ADC value between clear cell carcinoma and non-clear cell renal carcinoma was statistically significant（P〈0.05）.ADC value in the diagnosis of clear cell carcinoma was of highaccuracy with a selected ADC value of 1.380 × 10^-3mm^2/s,a sensitivity of 97.4% and a specificity of 66.7%.Conclusion DTI could distinguish benign from malignant renal lesions and had some value in inferring the type of malignant tumors.

关 键 词：磁共振成像 扩散张量成像 肾实性肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]