【摘要】：目的:評價定量IVIM參數(shù)對腎乏脂性錯構(gòu)瘤與乳頭狀腎細胞癌的鑒別診斷價值。方法:47例經(jīng)手術病理證實的腎臟乏脂性錯構(gòu)瘤(n=21)與腎乳頭狀細胞癌(n=26)患者術前采用3.0T MR進行多b值DWI(b值為0~1700s/mm2)掃描�；陔p指數(shù)模型計算相應的IVIM參數(shù):純擴散系數(shù)(D),假擴散系數(shù)(D*),灌注分數(shù)(f)。采用獨立樣本t檢驗或Mann-Whitney U檢驗進行分析兩組腫瘤的IVIM參數(shù),采用受試者工作特征曲線分析IVIM參數(shù)對兩組腫瘤的鑒別價值。結(jié)果:乳頭狀腎細胞癌f值明顯低于腎乏脂性錯構(gòu)瘤(0.227±0.077vs 0.417±0.117,P0.001);D值明顯高于腎乏脂性錯構(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統(tǒng)計學意義(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:腎乏脂性錯構(gòu)瘤與乳頭狀腎細胞癌的定量IVIM擴散與灌注參數(shù)值具有一定差異。灌注分數(shù)f可用于術前兩者的鑒別診斷。
[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】： 華中科技大學同濟醫(yī)學院附屬同濟醫(yī)院放射科;
【基金】：國家自然科學基金(81271529) 國家自然科學青年基金(81501447)
【分類號】：R445.2;R737.11

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