磁共振T2WI信号强度联合DWI-ADC值在肾透明细胞癌与乏脂型肾血管平滑肌脂肪瘤鉴别诊断中的应用  

Application of Magnetic Resonance T2WI Signal Intensity Combined with DWI-ADC Value in the Differential Diagnosis of Clear Cell Renal Cell Carcinoma and Fat-poor Renal Angiomyolipoma

作　　者：陈琳 庞文文 张楠 吕津津 王欣悦 Chen Lin;Pang Wen-wen;Zhang Nan;Lv Jin-jin;Wang Xin-yue(Imaging Center,Shijiazhuang People's Hospital,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]石家庄市人民医院影像中心,河北石家庄050000

出　　处：《中国CT和MRI杂志》2024年第9期114-116,共3页Chinese Journal of CT and MRI

基　　金：核磁共振脂肪定量分析技术(IDEAL-IQ)在肾上腺占位疾病中的应用的初步探讨(211201203)石家庄市科学技术研究与发展计划项目。

摘　　要：目的分析磁共振成像(MRI)T2加权图像(T2WI)信号强度(SI-T2)比值联合扩散加权成像(DWI)-表观扩散系数(ADC)比值在肾透明细胞癌(ccRCC)与乏脂型肾血管平滑肌脂肪瘤(fpAML)鉴别诊断中的应用意义。方法回顾性分析2021年3月至2024年3月我院收治的接受术前常规MRI检查并经手术标本病理学证实的ccRCC患者62例(设为ccRCC组)和fpAML患者45例(设为fpAML组)的临床资料。全部患者均于术前行MRI平扫和DWI序列扫描,记录MRI征象,同时测量并计算SI-T2比值(肿瘤SI-T2/同侧正常肾皮质SI-T2)和DWI-ADC比值(肿瘤DWI-ADC值/同侧正常肾皮质DWI-ADC值)。采用受试者工作特性曲线(ROC)评价MRI SI-T2比值、DWI-ADC比值单独及联合鉴别诊断ccRCC与fpAML的效能。结果62例ccRCC患者病灶最大径为1.20~6.20(2.90±0.58)cm;36例(58.06%)病灶最大径<4.00cm,均属实性肿块,26例(41.94%)病灶最大径≥4.00cm,主要表现为以实性为主的囊实性肿块,ccRCC实性部分T1WI呈等低信号,T2WI呈略高或混杂等高信号,DWI呈稍高信号。45例fpAML患者病灶最大径0.85~4.30(1.80±0.36)cm;病灶均为实性肿块,信号略欠均匀,T1WI呈等低信号,T2WI以等或略低信号为主,DWI呈稍高信号。ccRCC组病灶最大径显著高于fpAML组(P<0.001)。ccRCC组MRI SI-T2比值显著高于fpAML组(P<0.001),DWI-ADC比值显著低于fpAML组(P<0.05)。ROC曲线分析显示,MRI SI-T2比值、DWI-ADC比值对ccRCC与fpAML均有一定鉴别诊断效能,曲线下面积分别为0.747、0.809;两项联合鉴别诊断ccRCC与fpAML的曲线下面积为0.890。结论MRI SI-T2比值、DWI-ADC比值均能有效鉴别诊断ccRCC与fpAML,而两项联合可进一步提高鉴别诊断效能,值得临床验证。Objective To analyze the significance of magnetic resonance imaging(MRI)T2 weighted images(T2WI)signal intensity(SI-T2)ratio combined with diffusion weighted imaging(DWI)-apparent diffusion coefficient(ADC)ratio in the differential diagnosis of clear cell renal cell carcinoma(ccRCC)and fat-poor renal angiomyolipoma(fpAML).Methods The clinical data of 62 patients with ccRCC(ccRCC group)and 45 patients with fpAML(fpAML group)admitted to our hospital from March 2021 to March 2024 who received preoperative routine MRI examination and were confirmed by surgical specimen pathology were retrospectively analyzed.All patients underwent MRI plain scan and DWI sequential scan before surgery,and MRI signs were recorded.At the same time,SI-T2 ratio(tumor SI-T2/ipsilateral normal renal cortex SI-T2)and DWI-ADC ratio(tumor DWI-ADC value/ipsilateral normal renal cortex DWI-ADC value)were measured and calculated.Receive operating characteristic(ROC)was used to evaluate the efficacy of MRI SI-T2 ratio and DWI-ADC ratio in the differential diagnosis of ccRCC and fpAML alone and in combination.Results The maximum focal diameter of 62 ccRCC patients was 1.20~6.20(2.90±0.58)cm;36 cases(58.06%)had lesions with a maximum diameter of less than 4.00 cm,all of which were solid masses,26 cases(41.94%)had a maximum diameter of≥4.00 cm,mainly presenting as solid cystic masses.The solid portion of ccRCC showed isolow signal on T1WI,slightly high or mixed isohigh signal on T2WI,and slightly high signal on DWI.The maximum focal diameter of 45 fpAML patients was 0.85~4.30(1.80±0.36)cm;All lesions were solid masses with slightly uneven signals.T1WI showed equal low signal,T2WI showed equal or slightly low signal,and DWI showed slightly high signal.The maximum lesion diameter in ccRCC group was significantly higher than that in fpAML group(P<0.001).The MRI SI-T2 ratio in ccRCC group was significantly higher than that in fpAML group(P<0.001),and the DWIADC ratio was significantly lower than that in fpAML group(P<0.05).ROC curve analysis showed t

关 键 词：磁共振成像 T2加权图像 扩散加权成像 表观扩散系数 肾透明细胞癌 乏脂型肾血管平滑肌脂肪瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]