【摘要】：目的:評(píng)價(jià)定量IVIM參數(shù)對(duì)腎乏脂性錯(cuò)構(gòu)瘤與乳頭狀腎細(xì)胞癌的鑒別診斷價(jià)值。方法:47例經(jīng)手術(shù)病理證實(shí)的腎臟乏脂性錯(cuò)構(gòu)瘤(n=21)與腎乳頭狀細(xì)胞癌(n=26)患者術(shù)前采用3.0T MR進(jìn)行多b值DWI(b值為0~1700s/mm2)掃描�；陔p指數(shù)模型計(jì)算相應(yīng)的IVIM參數(shù):純擴(kuò)散系數(shù)(D),假擴(kuò)散系數(shù)(D*),灌注分?jǐn)?shù)(f)。采用獨(dú)立樣本t檢驗(yàn)或Mann-Whitney U檢驗(yàn)進(jìn)行分析兩組腫瘤的IVIM參數(shù),采用受試者工作特征曲線分析IVIM參數(shù)對(duì)兩組腫瘤的鑒別價(jià)值。結(jié)果:乳頭狀腎細(xì)胞癌f值明顯低于腎乏脂性錯(cuò)構(gòu)瘤(0.227±0.077vs 0.417±0.117,P0.001);D值明顯高于腎乏脂性錯(cuò)構(gòu)瘤[(0.745±0.197)×10-3 mm2/s vs(0.610±0.117)×10-3 mm2/s,P0.05],D*在兩種腫瘤間差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.085)。IVIM參數(shù)值鑒別兩者的AUC、敏感度、特異度和診斷閾值分別為f:0.918、91.3%、85.2%和0.312,D:0.684、51.9%、95.7%和0.789×10-3 mm2/s。結(jié)論:腎乏脂性錯(cuò)構(gòu)瘤與乳頭狀腎細(xì)胞癌的定量IVIM擴(kuò)散與灌注參數(shù)值具有一定差異。灌注分?jǐn)?shù)f可用于術(shù)前兩者的鑒別診斷。
[Abstract]:Objective: to evaluate the value of quantitative IVIM in differential diagnosis of renal hypolipidemic hamartoma and papillary renal cell carcinoma. Methods: a total of 47 patients with renal dyslipidemic hamartoma (NM21) and renal papillary cell carcinoma (NM26) were examined with 3. 0T MR (0~1700s/mm2) before operation. Calculation of corresponding IVIM parameters based on double exponential Model: pure Diffusion coefficient (D), false Diffusion coefficient (D *), Perfusion fraction (f). T test and Mann-Whitney U test were used to analyze the IVIM parameters of the two groups of tumors. The differential value of IVIM parameters in the two groups of tumors was analyzed by using the operating characteristic curve of the subjects. Results: the f value of papillary renal cell carcinoma was significantly lower than that of renal hypolipidemic hamartoma (0.227 鹵0.077vs 0.417 鹵0.117 P0.001). The D value was significantly higher than that of renal hypolipidemic hamartoma [(0.745 鹵0.197) 脳 10 ~ (-3) mm2/s vs (0.610 鹵0.117) 脳 10 ~ (-3) mm2/s,P0.05]. D* there was no significant difference between the two types of tumors (the sensitivity, specificity and diagnostic threshold of Pn0. 085). IVIM parameter were 85.2% and 0.312D: 0.684%, 51.9%, respectively), and the diagnostic thresholds were f: 0.91818 / 91.3% and 0.312D: 0.684 / 51.9, respectively. 95.7% and 0.789 脳 10-3 mm2/s. Conclusion: the quantitative IVIM diffusion and perfusion parameters of renal hypolipidemic hamartoma and papillary renal cell carcinoma are different. The perfusion fraction f can be used in the differential diagnosis of both before and after operation.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院放射科;
【基金】：國(guó)家自然科學(xué)基金(81271529) 國(guó)家自然科學(xué)青年基金(81501447)
【分類號(hào)】：R445.2;R737.11

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