摘要
目的探讨多参数肾脏磁共振成像(magnetic resonance imaging,MRI)评价肾细胞癌(renal cell carcinoma,RCC T)分期的准确性。材料与方法收集2012年6月至2018年6月在北京大学第一医院泌尿外科经手术病理证实为RCC的187例患者术前肾脏MR影像资料,以病理结果为金标准,依据肾细胞癌TNM分期的T分期标准,评价:(1)不同序列图像(T2WI、DWI及增强扫描门脉期T1WI)测量肿瘤最大径的准确性;(2)肿瘤侵犯肾周/肾窦脂肪的准确性;(3)伴有肾静脉瘤栓的准确性。采用Kappa检验评价多参数MRI与手术病理评价肾细胞癌T分期的一致性。结果 T2WI、DWI、增强T1WI序列图像上测量肿块最大径分别为(5.22±3.28) cm、(5.03±3.08) cm、(5.31±3.37) cm,病理测量肿块最大径为(5.24±3.59) cm,经Wilcoxon秩和检验四者间无显著差异。以瘤周脂肪间隙出现条片或结节灶作为增强MR判定瘤周脂肪浸润的标准,其敏感度、特异度、阳性预测值、阴性预测值分别为88.7%、88.1%、74.6%和95.2%。MRI评价肾静脉瘤栓的敏感度、特异度、阳性预测值及阴性预测值分别为90.9%、99.2%、98.0%、96.4%。MRI判定肾癌T分期与病理肿瘤T分期的一致性检验加权Kappa值为0.81。结论 RCC患者术前多参数MRI检查,能够较准确地判定肿瘤T分期,为临床治疗方法的选择提供有效信息。
Objective:To evaluate the accuracy of renal cell carcinoma(RCC)T staging by multi-parameter MR scan.Materials and methods:Through ethical approval,collected in June 2012 to June 2018 in Peking university first hospital uropoiesis surgical department confirmed by surgery pathology of renal cell carcinoma of 187 cases of patients with preoperative renal MR image data,with the pathological results as the gold standard,on the basis of renal cell carcinoma TNM staging T staging criteria evaluation:(1)The different sequence images(T2WI,DWI and enhanced scan portal T1WI)can measure the tumor size on the accuracy of the largest.(2)Accuracy of tumor invasion of perirenal/renal sinus fat.(3)Accuracy of thrombus with renal vein tumor.Kappa test was used to evaluate the consistency of multi-parameter MR and surgical pathology to evaluate the T staging of RENAL cell carcinoma.Results:The maximum diametres measured by T2WI,DWI and enhanced T1WI sequence images were(5.22±3.28)cm,(5.03±3.08)cm and(5.31±3.37)cm,respectively.The maximum diametres measured by pathology were(5.24±3.59)cm,and there was no significant difference between the four groups by Wilcoxon rank sum test.The sensitivity,specificity,positive predictive value and negative predictive value were 88.7%,88.1%,74.6%and 95.2%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of MR in the evaluation of renal vein tumor thrombus were 90.9%,99.2%,98.0%and 96.4%,respectively.The weighted Kappa value of MR for determining T stage of renal carcinoma and pathological tumor was 0.81.Conclusions:Preoperative multi-parameter MR examination for RCC patients can accurately determine tumor T stage and provide effective information for the selection of clinical treatment.
作者
刘铁钢
马明明
秦乃姗
LIU Tiegang;MA Mingming;QIN Naishan(Department of CT/MR,People's Hospital of Horqin Youyiqianqi,Xing'an League,Inner Mongolia,Ulanhot 137400,China;Department of Radiology,Peking University First Hospital,Beijing 100032,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2021年第7期60-63,共4页
Chinese Journal of Magnetic Resonance Imaging
关键词
多参数
肾脏
肾细胞癌
肿瘤T分期
磁共振增强成像
multi-parameter
renal
renal cells carcinoma
tumor T stage
enhanced magnetic resonance imaging
