Dixon联合磁敏感加权成像鉴别肾脏偶发性实性肿块的良恶性

Dixon Combined with Susceptibilityweighted Imaging to Differentiate the Benign and Malignant Incidental Solid masses in the Kidney

目的 探讨Dixon联合磁敏感加权成像(SWI)鉴别肾脏偶发性实性肿块良恶性的价值。方法 回顾性分析128例恶性和29例良性肾脏偶发性实性肿块的MRI图像。肿块在Dixon反相位上出现信号减低区,且对应的同相位和纯脂肪相上表现为高信号,认为含有成熟脂肪;排除脂肪、血管后,肿块在SWI上出现低信号区,认为含有出血。Dixon显示有成熟脂肪,或Dixon显示无成熟脂肪且SWI显示无瘤内出血,、判定肿块为良性;Dixon显示无成熟脂肪,但SWI显示有瘤内出血,判定肿块为恶性。分析Dixon联合SWI鉴别良恶性的诊断效能。结果 128例恶性肿块内均无成熟脂肪;29例良性肿块中22例有成熟脂肪。128例恶性肿块中124例有出血;29例良性肿块中仅1例有出血。128例恶性肿块中,判定为恶性124例、良性4例;29例良性肿块中,判定为良性28例、恶性1例。Dixon联合SWI鉴别肿块良恶性的正确率为96.8%。结论 Dixon联合SWI有助于鉴别肾脏偶发性实性肿块的良恶性。

Objective To explore the value of Dixon combining with susceptibility-weighted imaging in evaluating the benign and malignant renal incidental solid masses.Methods The Dixon and SWI images with128 cases of malignant and 29 cases of benign renal incidental solid masses confirmed by pathology examination were retrospectively analyzed.On the Dixon image,the mass has a signal reduction area on the opposed-phase image,and the corresponding in-phase and fat phase appear as high signal,which was considered to contain mature fat.After excluding fat and blood vessels,the tumor showed a low signal a rea on the SWI image,which was considered to contain hemorrhage.Dixon com bined with SWI to analyze the benign and malignant of all tumors.Dixon showed mature fat,or Dixon showed no mature fat and SWI showed no intratumoral hemorrhage,then the mass was judged to be benign.Dixon showed no mature fat,but SWI showed intratumoral hemorrhage,then the tumor was judged to be malignant.Using pathology as the gold standa rd,the diagnostic efficacy of Dixon com bining with SWI in differentiating the benign and malignant renal incidental solid masses was calculated.Results Dixon showed:there was no mature fat in 128 malignant masses;among 29 benign masses,22 cases had a small amount of mature fat and 7 cases had no mature fat.SWI showed:among 128 malignant masses,124 cases had hemorrhage and 4 cases had no hemorrhage;among 29 benign masses,1 case had hemorrhage and 28 cases had no hemorrhage.Among 128 malignant masses:124 cases were judged as malignant and 4 cases were judged as benign by Dixon combining with SWI.Among29 cases of benign masses,28 cases were judged as benign and 1 case was judged as malignant by Dixon combining with SWI.The precision,sensitivity,and specificity of Dixon combining with SWI in differentiating the benign and malignant renal incidental solid masses were 96.8%,96.9%,and 96.6%,respectively.Conclusion Dixon combining with SWI can help to differentiate benign from malignant incidental solid mass in the kidney.