肾透明细胞癌病理级别与磁敏感成像表现的相关性研究

Assessment of Intratumoral Micromorphology in Clear Cell Renal Cell Carcinoma Using Susceptibility Weighted Imaging: Comparative Analysis with Histopathology

目的用磁敏感加权成像(SWI)术前评价肾透明细胞癌(CRCC)的分级。方法回顾性分析37例经病理证实的CRCC患者的SWI征象。肿瘤内磁敏感信号(intratumoral susceptibility signal intensity,ITSS)的评估指标包括:ITSS是否存在、ITSS的主要结构、ITSS与肿瘤面积的比值。应用Mann-Whitney检验对结果进行统计学分析。结果除4例低级别CRCC患者,其余CRCC患者SWI上均见到ITSS。低级别和高级别CRCC ITSS主要结构的分布存在显著差异。与高级别CRCC(1.27±0.47)相比,低级别CRCC(2.15±1.05)可见较多血管结构、较少出血(P<0.005)。高级别CRCC(1.55±0.52)ITSS与肿瘤面积的比值明显高于低级别CRCC(0.88±0.43)(P<0.005)。结论 SWI对术前CRCC的病理分级有意义。

Objective To evaluate the intratumoral micromorphology in Clear Cell Renal Cell Carcinoma （CRCC） u- sing SWI. Methods 37 patients with pathologically proved CRCCs underwent SWI examination. The SWI features were retrospectively analyzed. The characteristics of intratumoral susceptibility signal intensity （ITSS）, including morphology of ITSS, dominant structure of ITSS and ratio of ITSS area to tumor area, were assessed on SWI. The results were compared by nonparametric Mann Whitney test. Results ITSS was seen in all lesions except 4 lesions of low grade CRCCs. There was significant difference of dominant structures of ITSS between low and high grade CRCCs. Specifically, more dominant vascular structures and less hemorrhage were seen in low-grade tumors （ 2. 15 ±1.05 ） than that in high-grade tumors （ 1.27 ± 0.47 ） （ P 〈 0. 005 ）. The ratio of ITSS area to tumor area was also significantly higher in high-grade tumors （ 1.55±0.52） than that in low grade tumors （0.88 ±0.43 ） on SWI （ P 〈 0. 005 ）. Conclusion SWI is useful for grading CRCCs before operation.