3.0T磁共振弥散加权成像表观弥散系数对肾脏肿瘤性病变的诊断价值  

Diagnostic value of 3.0T magnetic resonance DWI quantitative imaging in renal neoplasm

作　　者：陆蓉[1] 胥常云 林璐 金梅[1] 包雪平[1] 曹亮[1] 刘晓艳[1] 黄华[4] LU Rong;XU Chang-yun;LIN Lu;JIN Mei;BAO Xue-ping;CAO Liang;LIU Xiao-yan;HUANG Hua(Department of Imaging,the Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,China;Department of Imaging,the Third People＇s Hospital of Yancheng,Yancheng 224001,Jiangsu,China;Department of Radiology,the First People＇s Hospital of Changzhou,Changzhou 213000,Jiangsu,China;Department of Pathology,the Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,China)

机构地区：[1]南通大学附属医院影像科,南通226001 [2]盐城市第三人民医院影像科,盐城224001 [3]常州市第一人民医院放射科,常州213000 [4]南通大学附属医院病理科,南通226001

出　　处：《中国临床医学》2018年第4期601-605,共5页Chinese Journal of Clinical Medicine

基　　金：南通市科技局资助项目(HS2014065)~~

摘　　要：目的:探讨3.0T磁共振(MRI)弥散加权成像(DWI)量化指标对肾脏肿瘤性病变的诊断和鉴别诊断价值。方法:收集行肾脏MRI检查并经病理确诊的肾脏实质肿瘤89例。其中,肾细胞癌60例,包括39例肾透明细胞癌、8例乳头状肾细胞癌、9例肾嫌色细胞癌、4例多房囊性肾细胞癌;良性病变29例,包括肾血管平滑肌脂肪瘤25例,嗜酸细胞瘤4例。所有患者采用GE Signa HD 3.0T MR进行横断面DWI成像并行表观弥散系数(apparent diffusion coefficient,ADC)值测量。结果:肾透明细胞癌、乳头状肾细胞癌、肾嫌色细胞癌、多房囊性肾细胞癌ADC平均值分别为(1.681 5±0.176 9)×10^(-3)、(1.165 0±0.217 0)×10^(-3)、(1.121 0±0.231 6)×10^(-3)、(2.030 0±0.235 1)×10^(-3) mm^2/s,肾血管平滑肌脂肪瘤、肾嗜酸细胞瘤ADC平均值分别为(1.155 2±0.132 0)×10^(-3)、(1.580 0±0.212 3)×10^(-3) mm^2/s。肾透明细胞癌ADC值与乳头状肾细胞癌、肾嫌色细胞癌、肾血管平滑肌脂肪瘤ADC值差异均有统计学意义(P=0.000);而与多房囊性肾细胞癌、肾嗜酸细胞瘤ADC值差异无统计意义。结论:3.0T MR-DWI成像ADC值对肾脏肿瘤性病变具有鉴别诊断价值,有利于指导患者治疗方案的选择。Objective：To investigate the value of 3.0 T magnetic resonance （MR） DWI quantitative imaging in the diagnosis and differential diagnosis of renal neoplasm. Methods：Eighty-nine cases of renal parenchymal tumors diagnosed by pathology after renal MR examination were collected. Among them, 60 cases were renal cell carcinoma, including 39 cases of clear cell renal cell carcinoma, 8 cases of papillary renal cell carcinoma, 9 cases of chromophobe renal cell carcinoma, 4 cases of multilocular cystic renal cell carcinoma; and 29 cases were benign renal tumors, including 25 cases of renal angiomyolipoma, and 4 cases of renal oncocytoma. Cross sectional DWI imaging were performed in all patients using GE Signa HD 3.0 T MR scanner. Results：The mean ADC values of 39 cases of clear cell renal cell carcinoma, 8 cases of papillary renal cell carcinoma,9 cases of chromophobe renal cell carcinoma, 4 cases of multilocular cystic renal cell carcinoma, 25 cases of renal angiomyolipoma and 4 cases of renal oncocytoma were （1.681 5±0.176 9）×10-3, （1.165 0±0.217 0）×10-3, （1.121 0± 0.231 6）×10-3, （2.030 0±0.235 1）×10-3, （1.155 2±0.132 0）×10-3, and （1.580 0±0.212 3）×10-3 mm2/s, respectively. Compared with papillary renal cell carcinoma, chromophobe renal cell carcinoma, and renal angiomyolipoma, clear cell renal cell carcinoma had significant higher ADC value （P=0.000）. There were no statistically significant differences between the ADC value of clear cell renal cell carcinoma and those of multilocular cystic renal cell carcinoma, clear cell renal cell carcinoma, or renal oncocytoma. Conclusions：3.0 T MR-DWI quantitative imaging has a diagnostic and differential diagnostic value for renal tumor lesions, and has guiding value for the choice of therapeutic regimen.

关 键 词：肾脏肿瘤 磁共振成像 弥散成像 量化 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]