Papillary renal carcinoma: Diagnostic approach by chemical shift gradient-echo and echo-planar MR imaging
Papillary renal carcinoma: Diagnostic approach by chemical shift gradient-echo and echo-planar MR imaging
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DOI：
10.1002/jmri.20509
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发表时间：
2006-03-01
影响因子：
4.4
通讯作者：
Honda, H
中科院分区：
文献类型：
--
作者：
Yoshimitsu, K;Kakihara, D;Honda, H
目的：阐明MRI是否可以检测RCpap内间质组织细胞中的脂肪和含铁血黄素（Hs）沉积（两者都是乳头状肾癌（RCpap）的组织学特征）。 材料与方法：回顾性研究9例手术确诊的RCpap和57例透明细胞肾癌（RCcc）病例的术前MR图像。评估病变的固体成分。用于脂肪检测。使用化学位移 MRI (CSI) 反相图像上的信号减少。对于 Hs 检测，使用了 CSI 平面回波图像或同相图像上的信号减少。比较 RCpap 和 RCcc 之间的脂肪和 Hs 检测率。结果：在 9 个 RCpap 中的 5 个（54%）和 57 个 RCcc 中的 38 个（67%）中，CSI 提示肿瘤内存在脂肪（P = 0.71）。在九个 RCpap 中的 9 个 (100%) 和 57 个 RCcc 中的 28 个 (51%) 中，EPI 或 CSI 表明 Hs 沉积在肿瘤内 (P = 0.0036)。 RCpap 中观察到的 Hs 没有或没有坏死或出血，而 RCce 中的 Hs 主要位于坏死周围。 结论：通过 EPI 或 CSI 检测瘤内 Hs，特别是与坏死或出血无关的 Hs，可能有助于区分 RCpap 和 RCcc。
Purpose: To elucidate whether MRI can detect fat in interstitial histiocytes and hemosiderin (Hs) deposition (both of which are histological characteristics of papillary renal carcinoma (RCpap)) within RCpap.Materials and Methods: Preoperative MR images of nine surgically confirmed RCpap and 57 clear cell renal carcinoma (RCcc) cases were retrospectively studied. Solid components of the lesions were evaluated. For fat detection. signal reduction on opposed-phase images of chemical shift MRI (CSI) was used. For Hs detection, signal reduction on echo-planar images or in-phase images of CSI was used. The prevalence of fat and Hs detection was compared between RCpap and RCcc.Results: in five of nine RCpap (54%), and 38 of 57 RCcc (67%), the presence of fat: within the tumor was suggested by CSI (P = 0.71). Hs deposition within tumors was suggested by either EPI or CSI in nine of nine RCpap (100%), and 28 of 57 RCcc (51%) (P = 0.0036). Hs in RCpap was observed without or apart from necrosis or hemorrhage, whereas Hs in RCce was located predominantly around necrosis.Conclusion: Detecting intratumoral Hs by EPI or CSI, particularly that unrelated to necrosis or hemorrhage, may help differentiate RCpap from RCcc.