MRI扩散加权成像在乏脂肪肾血管平滑肌脂肪瘤和肾癌间的鉴别诊断价值

The differential diagnostic value of diffusion-weighted magnetic resonance imaging in RCC and RAML with minimal fat

目的:探讨MRI扩散加权成像(DWI)在乏脂肪肾血管平滑肌脂肪瘤(RAML)和肾癌间的鉴别诊断价值。方法:搜集2012年1月至2014年12月病理诊断RAML的患者137例,结合影像资料去除含明确脂肪的患者122例,具有完整MRI检查资料的乏脂肪RAML患者共15例,搜集2012年1月至2014年12月病理诊断肾癌并且具有完整MRI检查资料的患者31例,分析其MRI DWI信号特点,测量各病灶表面扩散系数(ADC)值,并分析其统计学差异。结果:15例乏脂肪RAML中,男6例,女9例,平均年龄(47±6.0)岁,ADC值为(1.62±0.18)×10-3 mm2/s;31例肾癌中,男14例,女17例,平均年龄(64±7.5)岁,透明细胞肾癌19例,乳头状肾癌7例,嫌色细胞肾癌5例,肾癌ADC值为(1.46±0.283)×10-3 mm2/s;乏脂肪RAML ADC值与肾癌ADC值差异有统计学意义(P<0.05);当ADC值阈值选择为1.57×10-3 mm2/s时,其鉴别诊断的敏感度和特异性分别为86.7%和77.4%。结论:乏脂肪RAML和肾癌的MRI DWI ADC值具有统计学差异;ADC值在乏脂肪RAML和肾癌的鉴别诊断中具有一定的价值。

Objective： To investigate the differential diagnostic value of diffusion-weighted magnetic resonance imaging in renal cell carcinoma and renal angiomyolipoma with minimal fat. Methods： One hundred and thirty-seven patients with pathological diagnosis RAML were collected from 2012.1 to 2014.12, 122 cases with definite mature adipose tissue were dismissed, and then 15 cases with integrated data of MRI were col- lected, and 31 cases of renal cell carcinoma with completely radiological materials were collected as well. These signal characteristics of diffusion=weighted magnetic resonance imaging were analyzed, the value of ADC in le- sion was measured, and their statistical differences were analyzed. Results： In 15 cases of RAML, 6 cases were male, 9 cases female, and the average age 47±6.0, the average value of ADC （1 .62±0.18）×10-3 mm2/s; and in 31 cases of RCC, 14 cases were male, 17 cases female, and the average age 63±7.5; 19 cases were clear-cell renal carcinoma, 7 cases were papillary renal carcinomas, and 5 cases chromophobe renal cell carcinoma, the average value of ADC was （1.460±0.283） × 10-3 mm2/s; the value of ADC was significant statistical difference （P〈0.05） in renal cell carcinoma and renal angiomyolipoma with minimal fat. The sensitivity and specificity of differential diagnostic was 86.7% and 77.4%, respectively, while the value of ADC selected was 1.57 × 10-3 mm2/s. Conelu= sion： The value of the ADC of diffusion-weighted magnetic resonance imaging in renal cell carcinoma and renal angiomyolipoma with minimal fat is significant difference; there are definitive diagnostic values in renal cell car- cinoma and renal angiomyolipoma with minimal fat.