定量IVIM参数对肾脏乏脂性错构瘤与乳头状细胞癌的鉴别诊断价值

发布时间：2018-11-23 10:22

【摘要】：目的:评价定量IVIM参数对肾乏脂性错构瘤与乳头状肾细胞癌的鉴别诊断价值。方法:47例经手术病理证实的肾脏乏脂性错构瘤(n=21)与肾乳头状细胞癌(n=26)患者术前采用3.0T MR进行多b值DWI(b值为0~1700s/mm2)扫描。基于双指数模型计算相应的IVIM参数:纯扩散系数(D),假扩散系数(D*),灌注分数(f)。采用独立样本t检验或Mann-Whitney U检验进行分析两组肿瘤的IVIM参数,采用受试者工作特征曲线分析IVIM参数对两组肿瘤的鉴别价值。结果:乳头状肾细胞癌f值明显低于肾乏脂性错构瘤(0.227±0.077vs 0.417±0.117,P0.001);D值明显高于肾乏脂性错构瘤[(0.745±0.197)×10-3 mm2/s vs(0.610±0.117)×10-3 mm2/s,P0.05],D*在两种肿瘤间差异无统计学意义(P=0.085)。IVIM参数值鉴别两者的AUC、敏感度、特异度和诊断阈值分别为f:0.918、91.3%、85.2%和0.312,D:0.684、51.9%、95.7%和0.789×10-3 mm2/s。结论:肾乏脂性错构瘤与乳头状肾细胞癌的定量IVIM扩散与灌注参数值具有一定差异。灌注分数f可用于术前两者的鉴别诊断。
[Abstract]:Objective: to evaluate the value of quantitative IVIM in differential diagnosis of renal hypolipidemic hamartoma and papillary renal cell carcinoma. Methods: a total of 47 patients with renal dyslipidemic hamartoma (NM21) and renal papillary cell carcinoma (NM26) were examined with 3. 0T MR (0~1700s/mm2) before operation. Calculation of corresponding IVIM parameters based on double exponential Model: pure Diffusion coefficient (D), false Diffusion coefficient (D *), Perfusion fraction (f). T test and Mann-Whitney U test were used to analyze the IVIM parameters of the two groups of tumors. The differential value of IVIM parameters in the two groups of tumors was analyzed by using the operating characteristic curve of the subjects. Results: the f value of papillary renal cell carcinoma was significantly lower than that of renal hypolipidemic hamartoma (0.227 卤0.077vs 0.417 卤0.117 P0.001). The D value was significantly higher than that of renal hypolipidemic hamartoma [(0.745 卤0.197) 脳 10 ~ (-3) mm2/s vs (0.610 卤0.117) 脳 10 ~ (-3) mm2/s,P0.05]. D* there was no significant difference between the two types of tumors (the sensitivity, specificity and diagnostic threshold of Pn0. 085). IVIM parameter were 85.2% and 0.312D: 0.684%, 51.9%, respectively), and the diagnostic thresholds were f: 0.91818 / 91.3% and 0.312D: 0.684 / 51.9, respectively. 95.7% and 0.789 脳 10-3 mm2/s. Conclusion: the quantitative IVIM diffusion and perfusion parameters of renal hypolipidemic hamartoma and papillary renal cell carcinoma are different. The perfusion fraction f can be used in the differential diagnosis of both before and after operation.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;
【基金】：国家自然科学基金(81271529) 国家自然科学青年基金(81501447)
【分类号】：R445.2;R737.11

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