多模态MRI鉴别外生性肾血管平滑肌脂肪瘤与肾周高分化脂肪肉瘤的价值  

The value of multimodal MRI in differentiating exophytic renal angiomyolipoma from perirenal well-differentiated liposarcoma

作　　者：张九龙 杨泽铖 叶雯[1] 施楠楠 张欣蕾 单飞[1] 施裕新[1] 张志勇[1,2] ZHANG Jiulong;YANG Zecheng;YE Wen;SHI Nannan;ZHANG Xinlei;SHAN Fei;SHI Yuxin;ZHANG Zhiyong(Department of Radiology,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;Shanghai Institute of Medical Imaging,Fudan University,Shanghai 200237,China)

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心放射科,上海201508 [2]复旦大学附属上海医学影像研究所,上海200237

出　　处：《实用放射学杂志》2023年第9期1439-1443,共5页Journal of Practical Radiology

基　　金：国家自然科学基金青年项目(82102116);上海市“医苑新星”青年医学影像人才培养资助计划项目(RC-YXYX-2021)。

摘　　要：目的探讨MRI征象、体素内不相干运动(IVIM)和扩散峰度成像(DKI)参数在鉴别外生性肾血管平滑肌脂肪瘤(AML)与肾周高分化脂肪肉瘤(WDLPS)的价值.方法回顾性分析8例外生性肾AML和27例肾周WDLPS的MRI表现.使用MITK Diffusion软件测量2组IVIM与DKI的灌注分数(f)、真扩散系数(D)、伪扩散系数(D^(*))、平均峰度(MK)和平均扩散率(MD)进行统计分析.结果外生性肾AML组中肾动脉分支供血(P<0.001)、肾皮质缺损(P=0.011)及瘤内血管扩张(P<0.001)发生比例显著高于肾周WDLPS组.外生性肾AML组的f值(P=0.002)和MK值(P=0.041)显著高于WDLPS组,而D值(P=0.002)和MD值(P=0.004)显著低于肾周WDLPS组.结论肾动脉分支供血、肾皮质缺损及瘤内血管扩张是识别外生性肾AML可靠征象;D、MD和f可作为区分两者合适的指标.Objective To investigate the value of MRI features,intravoxel incoherent motion(IVIM)and diffusion kurtosis ima-ging(DKI)parameters in differentiating exophytic renal angiomyolipoma(AML)from perirenal well-differentiated liposarcoma(WDLPS).Methods MRI findings of 8 cases of exophytic renal AML and 27 cases of perirenal WDLPS were analyzed retrospec-tively.The perfusion fraction(f),true-diffusion coefficient(D),pseudo-diffusion coefficient(D^(*)),mean kurtosis(MK)and mean diffusion(MD)of IVIM and DKI were measured by MITK Diffusion software for statistical analysis.Results The proportions of blood supply of renal artery branch(P<0.001),renal cortical defect(P=0.011)and intratumoral vascular dilatation(P<0.001)in exophytic renal AML group were significantly higher than those in perirenal WDLPS group.f(P=0.002)and MK values(P=0.041)in exophytic renal AML group were significantly higher than those in perirenal WDLPS group,while D(P=0.002)and MD values(P=0.004)were significantly lower than those in perirenal WDLPS group.Conclusion Blood supply of renal artery branch,renal cortical defect and intratumoral vascular dilatation are reliable signs for identifying exophytic renal AML.D,MD and f may be used as appropriate indicators todistinguish both.

关 键 词：血管平滑肌脂肪瘤 高分化脂肪肉瘤 磁共振成像 体素内不相干运动 扩散峰度成像 

分 类 号：R732.2[医药卫生—肿瘤] R738.6[医药卫生—临床医学] R445.2