扩散峰度成像定量参数在肾脏肿瘤诊断中的初步应用  

Preliminary application of DKI quantitative parameters in the diagnosis of renal tumors

作　　者：谭冰莹 陆蓉[2] 单海荣[1] 刘怡文[1] 罗一烽[1] 包雪平[2] 葛敏[2] 谢文超[1] TAN Bingying;LU Rong;SHAN Hairong;LIU Yiwen;LUO Yifeng;BAO Xueping;GE Min;XIE Wenchao(Department of Radiology,the Affiliated Yixing Hospital of Jiangsu University,Yixing,Jiangsu Province 214200,China;Department of Radiology,the Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226000,China)

机构地区：[1]江苏大学附属宜兴医院放射科,江苏宜兴214200 [2]南通大学附属医院放射科,江苏南通226000

出　　处：《实用放射学杂志》2020年第12期2020-2023,2032,共5页Journal of Practical Radiology

基　　金：南通市科技局资助项目(HS2014065)。

摘　　要：目的探讨DKI的定量参数在肾透明细胞癌(ccRCC)与血管平滑肌脂肪瘤(AML)诊断中的应用价值.方法选取经病理证实的38例肾肿瘤患者,其中ccRCC 23例,包括低级别(Ⅰ~Ⅱ级)18例,高级别(Ⅲ~Ⅳ级)5例;AML 15例.所有患者行常规腹部MR检查及DKI扫描.运用后处理软件生成DKI参数图.在连续3个病灶较大层面的病灶位置、瘤旁肾实质及对侧正常肾实质设置ROI,分别测量平均扩散系数(MD)和平均峰度(MK)参数,取其平均值.比较DKI参数在ccRCC与AML以及高级别和低级别ccRCC之间的差异,并分析参数最佳诊断界值.采用单因素方差分析比较ccRCC组内肿瘤病灶、瘤旁肾实质及对侧正常肾实质的各参数差异.结果MK及MD在ccRCC与AML之间的差异有统计学意义(P<0.05),对应的最佳诊断界值分别为0.58及1.86×10^-3 mm^2/s,敏感性、特异性和AUC分别为87%、75%和0.793;100%、62.5%和0.87.MK及MD在ccRCC低级别与高级别之间的差异有统计学意义(P<0.05),对应的最佳诊断界值分别为0.46及2.68×10^-3 mm^2/s,敏感性、特异性和AUC分别为77.8%、100%和0.933;77.8%、100%和0.944.ccRCC肿瘤、瘤旁肾实质及对侧正常肾实质三者之间的MK与MD值差异均有统计学意义(P<0.05).结论MK及MD值可用于ccRCC与AML的鉴别诊断,也可用于分析ccRCC对瘤旁肾实质的影响.Objective To explore the application of quantitative parameters of DKI in the diagnosis of clear cell renal cell carcinoma(ccRCC)and angiomyolipoma(AML).Methods A total of 38 lesions including 15 cases of AMI and 23 cases of ccRCC which were divided into 18 cases of low level(gradeⅠ-Ⅱ)and5 cases of high level(gradeⅢ-Ⅳ)were collected.All patients underwent conventional abdominal MR examination and DKI scan.The post-processing software DKI was used to generate the DKI parameter map.ROI was set in the lesion,para-tumor renal parenchyma and contralateral normal renal parenchyma at larger three consecutive layers.MK and MD values were measured respectively and the mean values were taken.DKI parameters were compared between AML and ccRCC,the high and low grades of ccRCC.ANOVA was used to compare the parameters of tumor lesion,para-tumor renal parenchyma and contralateral normal renal parenchyma in the ccRCC.Results The differences of MK and MD values between ccRCC group and AML group were statistically significant(P<0.05).The thresholds of MK and MD values were 0.58,1.86×10^-3 mm^2/s,and their corresponding sensitivity,specificity and AUC were 87%,75%and 0.793;100%,62.5%and 0.87.The differences of MK and MD values between high and low grades of ccRCC were statistically significant(P<0.05).The thresholds of MK and MD values were 0.46,2.68×10^-3 mm^2/s,and their corresponding sensitivity,specificity and AUC were 77.8%,100%and 0.933;77.8%,100%and 0.944.There were statistically significant differences of MK and MD values in the tumor lesion,para tumor renal parenchyma and contralateral normal renal parenchyma in the ccRCC group(P<0.05).Conclusion MK and MD values are of high value in differential diagnosis between ccRCC and AMIL.It can be used to analyze the effect of ccRCC on adjacent renal parenchyma.

关 键 词：扩散峰度成像 平均扩散系数 平均峰度 磁共振成像 肾脏肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.ll[医药卫生—诊断学]