定量动态增强MRI对肾透明细胞癌及乏脂肪肾血管平滑肌脂肪瘤的鉴别诊断价值

The value of quantitative dynamic contrast enhanced MRI in differential diagnosis of renal clear cell carcinoma and renal angiomyolipomas with minimal fat

目的探讨定量动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)对肾透明细胞癌、乏脂肪肾血管平滑肌脂肪瘤的鉴别能力。材料与方法收集38例经手术病理证实的肾脏肿瘤患者,其中肾透明细胞癌26例,乏脂肪肾血管平滑肌脂肪瘤12例,术前均行常规MRI、DCE-MRI扫描,选取感兴趣区测量肿瘤的动态增强定量参数Ktrans(容量转移常数)、Kep(速率常数)、Ve(血管外细胞外间隙容积比),并对得到的数据进行分析。结果经DCE-MRI检查的26例肾透明细胞癌患者中病灶区在动态增强扫描的早期强化,定量参数Ktrans、Kep、Ve均值分别为(0.625±0.313)min-1、(1.764±1.105)min-1、(-0.341±0.207);1 2例乏脂肪肾血管平滑肌脂肪瘤的定量参数Kt r a n s、Ke p、Ve均值分别为(0.061±0.023)min-1、(0.916±0.313)min-1、(-0.146±0.074)。Ktrans在肾透明细胞癌与乏脂肪肾血管平滑肌脂肪瘤间的差异有统计学意义(t=4.063,P<0.05),Kep、Ve在肾透明细胞癌与乏脂肪肾血管平滑肌脂肪瘤间的差异无统计学意义(t值分别为2.153、0.5,P>0.05)。结论定量DCE-MRI技术对肾透明细胞癌与乏脂肪肾血管平滑肌脂肪瘤有良好的鉴别诊断作用。

Objective：To explore the differential diagnosis value of quantitative dynamic contrast-enhanced MRI（DCE-MRI） of renal clear cell carcinoma and renal angiomyolipomas with minimal fat. Materials and Methods：Twenty-six cases with renal clear cell carcinoma, twelve cases with renal angiomyolipomas with minimal fat confirmed by operation, underwent the examination of MRI conventional scanning, and DCE-MRI. ROI were drawn to record the quantitative parameters average values of Ktrans, Kep, Ve. Results were statistically treated with SPSS 13.0.Results：Twenty-six cases with renal clear cell carcinoma showed obvious enhancement in the early phase of DCE-MRI. The Ktrans, Kep, Ve average value of renal cell carcinoma was （0.625±0.313） min-1, （1.764±1.105） min-1, （-0.341±0.207）, and the Ktrans, Kep, Ve average value of renal angiomyolipomas with minimal fat was （0.061±0.023） min-1, （0.916±0.313） min-1, （-0.146±0.074）. Ktrans value was statistically significant in the differences between renal cell carcinoma and renal angiomyolipomas with minimal fat. t value 4.063,P〈0.05.Conclusion：Quantitative DCE-MRI could differentiate renal clear cell carcinoma from renal angiomyolipomas with minimal fat.