多b值DWI的双指数函数分析在肾透明细胞癌术前分级中的应用分析

The biexponential analysis of diffusion weighted imaging with multi-b factors used for grading of clean cell renal cell carcinoma preoperatively

目的:探讨多b值DWI的双指数函数分析在肾透明细胞癌(Clear cell renal cell carcinoma,CCRCC)术前分级中的可行性。材料和方法:回顾性分析32例CCRCC患者的影像学资料及病理资料。以Fuhrman核分级法为依据分为低、高级别组,应用双指数函数分别计算两组的参数F、D fast和D slow。组间比较采用非参数检验(Mann-Whitney U);3个参数间的预测效能比较用受试者曲线分析。当P<0.05,认为差异有统计学意义。结果:低级别组20例,高级别组12例。与低级别的CCRCC相比较,高级别组的F减低,但是D fast、Dslow都增大,组间均存在统计学差异(U=18.0、20.0和15.5,P<0.05);3个参数预测高、低级别CCRCC的效能无统计学差异(P>0.05)。结论:CCRCC多b值DWI的双指数函数分析可以术前预测CCRCC的低、高级别。

Objective： To probe the feasibility of biexponential analysis of multi-b DWI used to the grading of the clear cell renal cell carcinoma （CCRCC） before the surgery. Material and Methods： The imaging and pathological data of 32 cases with CCRCC was assessed retrospectively. There were two groups confirmed by Fuhrman Grading, including high and low grade. Those parameters, including the F, Dfast and Dslowo, were compared between two groups using nonparametric test （Mann- Whitney U）, and the receiver operating characteristie（ROC） was used to test the predictive values in grading CCRCC preopera- tively. There was a significant difference when the P〈0.05. Results： Twenty cases of low grade（group 1） and 12 cases of high grade （group 2） CCRCCs were confirmed by pathology. Compared with group 1, the F decreased in group 2, but Dfast, t, Dslow in group 2 increased （U=18.0, 20.0 and 15.5, P〈0.05）. And the three parameters have the similar sensitivity and specificity for grading of CCRCC preoperatively （P〉0.05）. Conclusion： The biexponential analysis of multi-b DWI is suitable for the grading of CCRCC preoperatively.