Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours
Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours
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DOI：
10.1007/s00330-014-3107-z
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发表时间：
2014-05-01
影响因子：
5.9
通讯作者：
Grenier, N.
中科院分区：
文献类型：
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作者：
Cornelis, F.;Tricaud, E.;Grenier, N.
回顾性评价多参数磁共振（MR）成像鉴别肾肿瘤的能力。对2009年至2012年间连续100例经病理证实无宏观脂肪的实性肾肿瘤的MR图像进行了评估[57例透明细胞癌、16例乳头状肾癌和7例憎色肾细胞癌（RCCs）、16例嗜瘤细胞瘤和4例微量脂肪血管平滑肌脂肪瘤（AMLs）]。两名不了解病理结果的放射科医生独立审查了双回声化学位移、动态对比增强T1和t2加权图像和表观扩散系数（ADC）图。计算不同分期的信号强度指数（SII）、肿瘤-脾脏SI比（TSR）、ADC比、洗入指数（WiI）和洗出指数（WoI）。乳头状rcc与其他肾肿瘤的动脉WiI值（P < 0.001）、初始WoI值（P = 0.006）和ADC比（P < 0.001）差异有统计学意义；在TSR （P = 0.02）、实质WiI （P = 0.03）、晚期WiI （P = 0.02）、初始WoI （P = 0.03）和晚期WoI （P = 0.04）方面，憎色性rcc与癌细胞瘤之间存在差异；透明细胞rcc与癌细胞瘤SII （P = 0.01）和实质性WiI （P = 0.01）之间存在差异。乳头状rcc与其他肿瘤（敏感性37.5%，特异性100%）、嗜癌细胞瘤与憎色性rcc（敏感性25%，特异性100%）和透明细胞rcc（敏感性100%，特异性94.2%）有明显区别。磁共振成像提供了能够准确区分乳头状细胞癌与其他肿瘤以及嗜色细胞癌与透明细胞癌的标准。多参数MR参数能准确鉴别乳头状rcc，特异性高（100%）。癌细胞瘤与疏色性rcc有很高的特异性（100%）。欧分癌细胞瘤与透明细胞癌具有高特异性（94.2%）。在嗜瘤细胞病中，这些参数分析可以促进影像学随访。
To retrospectively evaluate the ability of multiparametric magnetic resonance (MR) imaging to differentiate renal tumours.MR images from 100 consecutive pathologically proven solid renal tumours without macroscopic fat [57 clear cell, 16 papillary and 7 chromophobe renal cell carcinomas (RCCs), 16 oncocytomas and 4 minimal fat angiomyolipomas (AMLs)] between 2009 and 2012 were evaluated. Two radiologists blinded to pathology results independently reviewed double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated.There were significant differences between papillary RCCs and other renal tumours for arterial WiI (P < 0.001), initial WoI (P = 0.006) and ADC ratio (P < 0.001); between chromophobe RCCs and oncocytomas for TSR (P = 0.02), parenchymal WiI (P = 0.03), late WiI (P = 0.02), initial WoI (P = 0.03) and late WoI (P = 0.04); and between clear cell RCCs and oncocytomas for SII (P = 0.01) and parenchymal WiI (P = 0.01). Papillary RCCs were distinguished from other tumours (sensitivity 37.5 %, specificity 100 %) and oncocytomas from chromophobe RCCs (sensitivity 25 %, specificity 100 %) and clear cell RCCs (sensitivity 100 %, specificity 94.2 %).MR imaging provides criteria able to accurately distinguish papillary RCCs from other tumours and oncocytomas from chromophobe and clear cell RCCs.aEuro cent Multiparametric MR parameters accurately distinguish papillary RCCs with high specificity (100 %).aEuro cent Oncocytomas can be distinguished from chromophobe RCCs with high specificity (100 %).aEuro cent Oncocytomas can be distinguished from clear cell RCCs with high specificity (94.2 %).aEuro cent In oncocytomatosis, imaging follow-up with such parameters analysis could be promoted.