常见肾细胞癌体素内非相干运动成像的临床应用

目的 应用磁共振扩散加权成像(DWI)中体素内非相干运动(intravoxelincoherentmotion,IVIM)模型分析常见肾细胞癌(renalcellcarcinoma,RCC)的影像特征,为指导临床个体化治疗提供更有价值的影像依据。方法回顾性分析行3.0T MRI多b值DWI检查且经外科病理证实的49例RCC患者,比较常见RCC亚型的表现扩散系数(ADC)值和IVIM 各参数值的差异。结果 透明细胞型肾细胞癌(clearcellRCC,ccRCC)和嫌色性肾细胞癌(chromophobeRCC,chRCC)的ADC值、假扩散系数(D*)值、灌注分数(f)值与乳头状肾细胞癌(papillaryRCC,pRCC)比较差异均有统计学意义(P <0.05),其组织扩散系数(D)值差异均无统计学意义;ccRCC和chRCC的相关各参数值差异均无统计学意义(P >0.05)。结论 ccRCC 和chRCC 都是富血供病变,其实性部分的ADC 值及IVIM 各参数值异无统计学意义;pRCC的ADC值、D*值和f值均低于ccRCC和chRCC;常见3种RCCs的D值差异无统计学意义。

Study of intravoxel incoherent motion imaging in common renal cell carcinoma

Objective To use intravoxel incoherent motion(IVIM) diffusion weighted imaging of renal cell carcinoma (RCC) for comparing their imaging difference， so as to provide more valuable imaging basis for guiding clinical individualized treatment. Methods A retrospective study was made in 49 patients with RCC demonstrated by surgical pathology and imaged at 3.0T MRI using 8 b values for diffusion weighted imaging， the values of ADC and IVIM parameters were compared between different subtypes of RCC. Results The values of ADC， pseudodiffusivity coefficient (D*) and perfusion fraction (f) of clear cell RCC(ccRCC) or chromophobe RCC(chRCC) compared with papillary RCC(pRCC) had statistically significant difference (P＜0.05)， but the value of tissue diffusivity (D) demonstrated no significant difference. Conclusion ccRCC and chRCC are hypervascular tumors， the values of ADC and IVIM parameters were no significant difference in the solid portion between ccRCC and chRCC. The values of ADC， D*and f were lower in pRCC than those of ccRCC and chRCC. The value of D demonstrates no significant difference between common subtypes of RCC.