[1]彭令荣,孔庆聪,刘卫敏,等.磁共振弥散加权成像信号强度评价透明细胞肾癌组织分化程度的价值[J].中华腔镜泌尿外科杂志(电子版),2018,12(01):47-52.[doi:10.3877/cma.j.issn.1674-3253.2018.01.013 ]
 Peng Lingrong,Kong Qingcong,Liu Weimin,et al.Value of diffusion weighted imaging signal intensity in exploring histopathological differentiation of clear cell renal cell carcinoma[J].,2018,12(01):47-52.[doi:10.3877/cma.j.issn.1674-3253.2018.01.013 ]
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磁共振弥散加权成像信号强度评价透明细胞肾癌组织分化程度的价值()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
12卷
期数:
2018年01期
页码:
47-52
栏目:
临床研究
出版日期:
2018-01-31

文章信息/Info

Title:
Value of diffusion weighted imaging signal intensity in exploring histopathological differentiation of clear cell renal cell carcinoma
作者:
彭令荣1孔庆聪1刘卫敏1陈健宁2邹艳1江婷1
510630 广州,中山大学附属第三医院放射科1,病理科2
Author(s):
Peng Lingrong1 Kong Qingcong1 Liu Weimin1 Chen Jianning2 Zou Yan1 Jiang Ting1.
Department of Radiology1, Department of Padiology2, the Third Affiliated Hospital of SUN Yat-sen University, Guangzhou 510630, China
关键词:
磁共振 弥散 透明细胞肾癌 信号强度 分化
DOI:
10.3877/cma.j.issn.1674-3253.2018.01.013
摘要:
目的 分析磁共振弥散加权成像(DWI)目测信号强度、量化信号强度(SI)值与透明细胞肾癌(CCRCC)的组织分化程度的关系,探讨DWI 信号强度评价CCRCC 的组织分化程度的价值。方法 回顾性收集经病理证实的CCRCC 患者91 例,并根据Fuhrman 病理分级Ⅰ~Ⅳ级标准,分为高分化组(Ⅰ级和Ⅱ级,37 例)、中分化组(Ⅲ级,32 例)、低分化组(Ⅳ级,22 例),所有患者均行中腹部MR 平扫、增强和DWI 检查(1.5 T,b=800 sec/mm2),分别目测CCRCC 的DWI 信号强度、测量SI 值,采用Kruskal-Wallis 秩和检验比较CCRCC 的DWI 目测信号强度与组织分化程度差异;采用单因素方差比较CCRCC 的 SI 值与组织分化程度的差异;采用Spearman 等级相关检验分析CCRCC 的组织分化程度与目测信号强度、SI 值的相关性;并采用受试者工作特征ROC 曲线评价CCRCC 的SI 值诊断高分化CCRCC、低分化CCRCC 的效能。结果 91 例CCRCC 的DWI 目测信号强度中,43.9% 呈明显高信号,30.8% 呈中等高信号,25.3% 呈等/ 略高信号。明显高信号组与等/略高信号组的CCRCC 的组织分化程度差异有统计学意义(P<0.05)。中等高信号组与等/ 略高信号组、中等高信号组与明显高信号组的CCRCC 组织分化程度差异均无统计学意义(P>0.05)。CCRCC的DWI 目测信号强度与组织分化程度呈中等的负相关(rs=-0.552,P<0.05)。高分化CCRCC 的SI 值明显低于中、低分化CCRCC,中分化CCRCC 的SI 亦低于低分化CCRCC(P<0.05)。CCRCC的SI 值与组织分化程度呈显著的负相关(r=-0.711,P<0.05)。受试者工作特征ROC 曲线分析显示DWI 的SI 值诊断高分化CCRCC 的最佳临界点值为273.7,相应的敏感度与特异度分别67.6%、98.2%;诊断低分化CCRCC 的最佳临界点值为378.9,相应的敏感度与特异度分别91.3%、59.1%。结论 随DWI 目测信号强度、SI 值升高,CCRCC 的组织分化程度降低。DWI 目测信号强度及SI 值预测CCRCC 组织分化程度有一定的临床价值。

参考文献/References:

[1] Chen J, Djing JL, Wu CP, et al. Preoperatively evaluating the correlation between pathological grades and oxygenation leveldependent MRI in clear renal cell carcinoma[J]. Acad Radiol, 2103,20(2): 224-230.
[2] Fukatsu A, Tsuzuki T, Sassa N, et al. Growth pattern, an important pathologic parameter for clear cell renal cell carcinoma[J]. Am J ClinPathol, 2013, 140(4): 500-505.
[3] Steffens S, Roos RC, Janssen M, et al. Clinical behavior of chromophobe renal cell carcinoma is less aggressive than that of clear cell renal cell carcinoma, independent of Fuhrman grade or tumor size[J]. VirchowsArchiv, 2014, 465(4): 439-444.
[4] Hotker AM, Mazaheri Y, Wibmer A, et al. Differentiation of clear renal cell carcinoma from other renal cortical tumors by use of a quantitative multiparametric MRI approach[J]. AJR Am J Roentgenol, 2017, 208(3): W85-W91.
[5] 王春喜, 芦志华. 保留肾单位手术的热点问题探讨[J/CD]. 中华腔镜泌尿外科杂志( 电子版), 2012, 6(6): 421-423.
[6] Teng J, Gao Y, Chen M, et al. Prognostic value of clinical and pathological factors for surgically treated localized clear cell renal cell carcinoma[J]. Chin Med(Engl), 2014, 127(9): 1640-1644.
[7] 李茂章, 廖锦先, 周晓波, 等. 后腹腔镜下与开放性肾癌根治术治疗局限性肾癌的比较[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2014, 8(3): 175-177.
[8] Goyal A, Sharma R, Bhalla, et al. Diffusion-weighted MRI in renal cell carcinoma: a surrogate marker for predicting nuclear grade and histological subtype[J]. ActaRadiol, 2012, 53(3): 349-358.
[9] Vargas HA, Delaney HG, Delappe EM, et al. Multiphasic contrastenhanced MRI: single-slice versus volumetric quantification of tumor enhancement for the assessment of renal clear cell carcionma Fuhrman grade[J]. J Magn Reson Imaging, 2013, 37(5): 1160-1167.
[9] Zhang H, Gan Q, Wu Y, et al. Diagnostic performance of diffusinoweighted magnetic resonance imaging in differentiating human renal lesion (benignity or malignance): a meta-analysis[J]. AbdomRadiol,2016, 41(10): 1997-2010.
[10] 丛欣莹, 陈雁, 张瑾, 等. 体素内不相干运动扩散加权成像在肾细胞癌诊断中的应用[J]. 中华肿瘤杂志, 2016, 38(6): 434-439.
[11] 王超, 王龙胜, 郑穗生, 等. 肾透明细胞癌Fuhrman 核分级与CT征象的关系[J]. 中国医学影像技术, 2015, 31(9): 1292-1296.
[12] Choi YA, Kim CK, Park SY, et al. Subtype differentiation of renal cell carcinoma using diffusion-weighted and blood oxygenation level-dependent MRI[J]. AJR Am J Roentqenol, 2014, 203(1): 78-48.
[13] Lassel EA, Rao R, Schwenk C, et al. Diffusion-weighted imaging focal renal lesion: a meta-analysis[J]. EurRadiol, 2014, 24(1 ):241-249.
[14] Chandarana H, Rosenkrantz AB, Mussi TC, et al. Histogram analysis of whole-lesion enhancement in differentiating clear cell from papillary subtype of renal cell cancer[J]. Radiology, 2012, 265(3):790-798.
[15] 丁玖乐, 邢伟, 陈杰, 等. 信噪比在肾透明细胞癌多b 值DWI 分析中的重要研究[J]. 中华医学杂志, 2014, 94(3): 171-173.
[16] Shen L, Zhou L, Liu X, et al. Comparison of biexponential and monoexponential DWI in evaluation of Fuhrman grading of clear cell renal carcinoma[J]. Diagn Interv Radiol, 2017, 23(2): 100-105.
[17] Mirka H, Korcakova E, Kastner J, et al. Diffusion-weighted imaging using 3.0T MRI as a possible biomarker of renal tumor[J]. Antainccer Res, 2015, 35(4): 2351-2357.

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备注/Memo

备注/Memo:
基金项目:广东省科技计划重大专项课题(2014B02022500)
通讯作者:江婷,Email:jiangtin@163.com
更新日期/Last Update: 2018-02-25