目的探讨磁共振T_(2)WI信号强度(T_(2)W I Signal Intensity,SI-T_(2))、表观扩散系数(ADC)值二者联合鉴别肾透明细胞癌(CCRCC)和乏脂型肾血管平滑肌脂肪瘤(fpAML)的价值。方法回顾性分析经手术病理证实的38例肾透明细胞癌和27例乏脂型...目的探讨磁共振T_(2)WI信号强度(T_(2)W I Signal Intensity,SI-T_(2))、表观扩散系数(ADC)值二者联合鉴别肾透明细胞癌(CCRCC)和乏脂型肾血管平滑肌脂肪瘤(fpAML)的价值。方法回顾性分析经手术病理证实的38例肾透明细胞癌和27例乏脂型肾血管平滑肌脂肪瘤患者的资料。所有患者术前均行MRI平扫和扩散加权成像(DWI)检查。对压脂T_(2)WI(T_(2)WI-FS)信号强度值SI-T_(2)及ADC值进行定量测量,记录病灶与正常肾组织的测量比值,采用多因素Logistic回归分析确定SI-T_(2)、ADC值联合鉴别两种肿瘤的独立影响因素,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)并做比较。结果肾透明细胞癌的SI-T_(2)比值高于乏脂型肾血管平滑肌脂肪瘤,信号强度的ROC AUC、灵敏度及特异度分别为0.725、85.5%和71.6%(P<0.05);肾透明细胞癌的ADC比值低于乏脂型肾血管平滑肌脂肪瘤(P<0.05),ADC测量的ROC AUC、灵敏度和特异性分别为0.812、79.8%和75.4%。SI-T_(2)联合ADC值的ROC分析发现,鉴别两者的AUC、敏感性及特异性分别为0.885,89.5%、83.6%。结论MRI T_(2)信号强度比值及ADC比值均有助于鉴别肾透明细胞癌和乏脂型肾血管平滑肌脂肪瘤,两种参数结合能更好的鉴别这两种肿瘤。展开更多
Fat-poor renal angiomyolipoma (fpAML) and renal cell carcinoma (RCC) are difficult to differentiate and misdiagnosis can lead to unnecessary nephrectomy. We experienced a case showing a “collapsed shape” which refle...Fat-poor renal angiomyolipoma (fpAML) and renal cell carcinoma (RCC) are difficult to differentiate and misdiagnosis can lead to unnecessary nephrectomy. We experienced a case showing a “collapsed shape” which reflected a fpAML tissue type. A renal tumor was incidentally discovered in a 42-year-old female during an abdominal ultrasound. RCC was suspected according to CT and MRI imaging results, and a partial nephrectomy was performed. However, the pathologic diagnosis was fpAML. Upon reevaluation of preoperative images, morphological change to the tumor due to contact with surrounding tissues: the collapsed shape was observed and could be identified by CT, which is the gold standard test for differentiating renal tumors. In cases where the collapsed shape is observed in a renal tumor, fpAML should be considered.展开更多
文摘目的探讨磁共振T_(2)WI信号强度(T_(2)W I Signal Intensity,SI-T_(2))、表观扩散系数(ADC)值二者联合鉴别肾透明细胞癌(CCRCC)和乏脂型肾血管平滑肌脂肪瘤(fpAML)的价值。方法回顾性分析经手术病理证实的38例肾透明细胞癌和27例乏脂型肾血管平滑肌脂肪瘤患者的资料。所有患者术前均行MRI平扫和扩散加权成像(DWI)检查。对压脂T_(2)WI(T_(2)WI-FS)信号强度值SI-T_(2)及ADC值进行定量测量,记录病灶与正常肾组织的测量比值,采用多因素Logistic回归分析确定SI-T_(2)、ADC值联合鉴别两种肿瘤的独立影响因素,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)并做比较。结果肾透明细胞癌的SI-T_(2)比值高于乏脂型肾血管平滑肌脂肪瘤,信号强度的ROC AUC、灵敏度及特异度分别为0.725、85.5%和71.6%(P<0.05);肾透明细胞癌的ADC比值低于乏脂型肾血管平滑肌脂肪瘤(P<0.05),ADC测量的ROC AUC、灵敏度和特异性分别为0.812、79.8%和75.4%。SI-T_(2)联合ADC值的ROC分析发现,鉴别两者的AUC、敏感性及特异性分别为0.885,89.5%、83.6%。结论MRI T_(2)信号强度比值及ADC比值均有助于鉴别肾透明细胞癌和乏脂型肾血管平滑肌脂肪瘤,两种参数结合能更好的鉴别这两种肿瘤。
文摘Fat-poor renal angiomyolipoma (fpAML) and renal cell carcinoma (RCC) are difficult to differentiate and misdiagnosis can lead to unnecessary nephrectomy. We experienced a case showing a “collapsed shape” which reflected a fpAML tissue type. A renal tumor was incidentally discovered in a 42-year-old female during an abdominal ultrasound. RCC was suspected according to CT and MRI imaging results, and a partial nephrectomy was performed. However, the pathologic diagnosis was fpAML. Upon reevaluation of preoperative images, morphological change to the tumor due to contact with surrounding tissues: the collapsed shape was observed and could be identified by CT, which is the gold standard test for differentiating renal tumors. In cases where the collapsed shape is observed in a renal tumor, fpAML should be considered.
