扩散加权成像对非透明细胞肾癌亚型的鉴别诊断价值

Diffusion Weighted Imaging in Differential Diagnosis of Non-clear Cell Renal Cell Carcinoma

目的探讨扩散加权成像(DWI)表观扩散系数(ADC)值对非透明细胞肾癌亚型的鉴别诊断价值。资料与方法经手术病理证实的48例非透明细胞肾癌患者,术前行DWI检查(b=0、800s/mm2)测定病变ADC值,比较不同亚型非透明细胞肾癌ADC值的差异。结果 48例共48个病灶,直径(3.8±2.3)cm,其中肾嫌色细胞癌(CRCC)20例,乳头状肾细胞癌(PRCC)28例(Ⅰ型18例,Ⅱ型10例)。CRCC的ADC值为(0.994±0.184)×10-3mm2/s,PRCC的ADC值为(0.860±0.114)×10-3mm2/s,差异有统计学意义(P<0.01);PRCCⅠ型ADC值为(0.908±0.085)×10-3mm2/s,Ⅱ型ADC值为(0.775±0.113)×10-3mm2/s,差异有统计学意义(P<0.01);CRCC和PRCCⅡ型ADC值差异有统计学意义(P<0.01),CRCC和PRCCⅠ型ADC值差异无统计学意义(P>0.05)。结论当b=800s/mm2时,ADC值可以鉴别CRCC和PRCCⅡ型,但不能鉴别PRCCⅠ型和CRCC。ADC值对鉴别非透明细胞肾癌亚型有一定帮助,但鉴别诊断效能不高。

Purpose To investigate the significance of apparent diffusion coefficient （ADC） in differential diagnosis of non-clear cell renal cell carcinoma. Materials and Methods Forty-eight patients with pathology-proven non-clear cell renal cell carcinoma underwent preoperative diffusion weighted imaging （b=0, 800 s/mm 2 ）. The ADC values in different subtypes were analyzed. Results There were 48 lesions in 48 patients with average tumor size of （3.8±2.3） cm, including 20 chromophobe cell renal cell carcinoma （CRCC） and 28 papillary renal cell carcinoma （PRCC） （18 typeⅠ, 10 typeⅡ）. The ADC was （0.994±0.184）×10 -3 mm 2 /s for CRCC, and （0.860±0.114）×10 -3 mm 2 /s for PRCC with statistical significance （P＆lt;0.01）. The ADC for type Ⅰ PRCC was （0.908±0.085）×10 -3 mm 2 /s and （0.775±0.113）×10 -3 mm 2 /s for type Ⅱ PRCC with statistical significance （P＆lt;0.01）. The ADC for CRCC was not significantly different from type Ⅰ PRCC （P＆gt;0.05）. Conclusion When b=800 s/mm 2 , ADC is useful in differentiate certain subtypes of non-clear cell renal cell carcinoma.