小视野DWI序列在评价直径≤4 cm肾透明细胞癌病理分级诊断中的应用  

Application of reduced field of view DWI sequence in the evaluation of pathological grade diagnosis of renal clear cell carcinoma with diameter≤4 cm

作　　者：陈杰[1] 史振峰[2] 王艳[1] 刘烁[1] 洪悦[1] Chen Jie;Shi Zhengfeng;Wang Yan;Liu Shuo;Hong Yue(Department of Radiology and Medical Imaging,the People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Urology,the People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院泌尿中心,乌鲁木齐830001

出　　处：《国际泌尿系统杂志》2021年第6期993-997,共5页International Journal of Urology and Nephrology

基　　金：新疆维吾尔自治区自然科学基金(2018D01C137)。

摘　　要：目的探讨小视野弥散加权成像(r-FOV DWI)序列在评价直径≤4 cm的肾透明细胞癌(ccRCC)病理分级诊断中的应用。方法回顾性分析2018年4月至2021年1月经病理证实的42例ccRCC患者的影像学及病理资料,根据病理情况分为低级别组(31例)和高级别组(11例),患者术前均行常规视野DWI(c-FOV DWI)及r-FOV DWI检查,比较两组患者的一般资料及不同FOV及b值下图像的信噪比(SNR)和对比噪声比(CNR);比较两组的表观扩散系数(ADC)值的差异,采用受试者工作特征曲线(ROC)分析两种方法在评估小ccRCC病理分级中的价值。结果两组患者的肿瘤直径、肿瘤分布部位、年龄、性别比较,差异均无统计学意义(P>0.05)。r-FOV DWI图像的SNR及CNR均优于c-FOV DWI(P<0.05),而且b=600 s/mm^(2)两种图像的SNR及CNR要略优于b=1000 s/mm^(2)(P<0.05);两组c-FOV DWI序列在不同b值下的ADC值比较,差异无统计学意义(P>0.05),而r-FOVDWI序列在不同b值下的ADC值比较,低级别组均高于高级别组,差异均有统计学意义(P<0.05),b=1000 s/mm^(2)时差异更明显(P=0.004)。r-FOV DWI序列b值取1000 s/mm^(2)时曲线下面积最大,当ADC值以1.36×10^(-3) mm^(2)/s为界值时,其鉴别高、低级别ccRCC的灵敏度、特异度分别为96.4%、81.8%。结论r-FOV DWI在鉴别直径≤4 cm的低级别及高级别ccRCC方面优于c-FOV DWI,图像质量更好。Objective To explore the application of reduced field of view DWI(r-FOV DWI)sequence in the evaluation of pathological grade diagnosis of renal clear cell carcinoma(ccRCC)with a diameter of≤4 cm.Methods The imaging and pathological data of 42 patients with ccRCC confirmed by pathology were retrospectively analyzed from April 2018 to January 2021.According to pathology,they were divided into low-grade group(31 cases)and high-grade group(11 cases).All patients underwent conventional field of view DWI(c-FOV DWI)and r-FOV DWI examination,the general clinical data of the two groups of patients were compared,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the images under different FOV and b values were compared,and the differences in apparent diffusion coefficient (ADC)values were compared between the two groups.The receiver operating characteristic curve(ROC)was used to analyze the value of two methods to assess the pathological grading of small ccRCC.Results There was no statistical difference between the two group in terms of tumor size,location,patient age and gender(P>0.05);the SNR and CNR of r-FOV DWI images were better than those of c-FOV DW1,and the SNR of b=600 s/mm^(2)images and CNR was slightly better than b=1000s/mm^(2);the ADC value of c-FOV DWI sequence was not statistically different between the two groups(P>0.05),The ADC values of r-FOV DWI sequence under different B values were higher in the low-grade group than in the high-grade group,and the differences were statistically significant(P<0.05),and the difference was more obvious when b=1000 s/mm^(2)(P=0.004).When the r-FOV DWI sequence b value was 1000 s/mm^(2),the area under the curve was the largest.When the ADC value was 1.36×10^(-3)mm^(2)/s as the boundary value,the sensitivity and specificity for distinguishing high and low-level ccRCC were 96.4%and 81.8%.Conclusions r-FOV DWI is superior to c-FOV DWI in distinguishing low-level and high-level ccRCC with a diameter of≤4 cm,and the image quality is better.

关 键 词：癌 肾细胞 磁共振成像 弥散 病理分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]