30t磁共振扩散加权成像应用于肾脏实质性肿瘤诊断及鉴别诊断的初步研究

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1、UndertheCurve,ROC)，曲线下面积为0.877,以1.27X10W7s为阈值，敏感度为78.3%,特异性为75%。(2)透明细胞癌高级别组肿瘤的平均ADC值(1.46±0.17XWW/S)低于低级别组肿瘤的平均ADC值(1.94土0.08X10_W/s),(pv0・05)。以透明细胞癌高低级别绘制ROC曲线，曲线下面积为0.808,以1.23X10_W/s为阈值，敏感度为90.5%,特异性为71.4%。(3)肿瘤、瘤旁肾实质及对侧正常肾实质组：组内比较：1)良性肿瘤的ADC值(0.93±0.12X10W/s)分别小于对侧正常肾

2、实质的ADC值(2.12±0.05X10_3mm2/s)及对侧瘤旁肾实质的ADC值(2・10土0.03X10W/s)(pv0.05),差异有统计学意义；2)良性肿瘤瘤旁肾实质与对侧正常肾皮质的ADC值差异无统计学意义(p>0.05)。3)恶性肿瘤的ADC值(1.72±0.09X10_W/s)分别小于对侧正常肾实质的ADC值(2.11土0.03X10_W/s)及对侧瘤旁肾实质的ADC值(2.01±0.03X10_3mm2/s),(p<0.05)；4)恶性肿瘤瘤旁肾实质(2.01±0.03X10ini『/s)小于对侧正常肾皮质的ADC值(2.l

3、l±0・03Xl(TW/s)(p<0.05),差异有统计学意义。组间比较:采用Mann-WhitneyU检验比较良性瘤旁与恶性瘤旁的ADC值、良性对侧肾实质与恶性对侧肾实质的ADC值及良性对侧肾实质、恶性对侧肾实质与志愿者肾实质的ADC值，差异无统计学意义。结论：磁共振弥散加权成像可用于肾脏良恶性肿瘤的定性诊断。ADC值可用于肾脏良恶性肿瘤及肾透明细胞癌不同级别的鉴别诊断。ADC值对观察肾脏恶性肿瘤对瘤旁肾实质的影响有一定价值。关键词：肾脏肿瘤，磁共振检查，扩散加权成像，表观扩散系数AbstractObjective:Tostudythed

4、iagnosticutilityofMagneticResonanceDiffusionweightedimaging(MRDWI)indifferentiatingrenalturno匚Toevaluatetheidentifiedvalueofapparentdiffusioncoefficient(ADC)indifferentiatingbenignfromthemalignantrenaltumors.differentiatingvariouspathologicgradesofrenalclearcellcarcinoma,a

5、ndanalyzingtheeffecttherenaltumorhadonperitumoralrenalparenchyma•MaterialsandMethods:35patientsand5healthyvolunteersunderwent3.0TconventionalMRIscanninganddiffusionweightedimagingscanningbeforesurgicaloperation.AllthepatientswereSurgicalandpathologicaldiagnosed.Amongthepat

6、ientswere16malesand19females(Age:21-72,Averagingage：48).5volunteersincluded3malesand2females(Age:22-41,Averagingage：31).DWIwereobtainedwithbvaluesof0,400and600s/mm2.Bytwoexperiencedradiologistsblindedreadingandanalyzeddata.UsingworkSyngoworkstationFoncToolsoftwareforDWIdat

7、apost-processing.ROI(regionofinterest)wasasfaraspossiblebigandatthesamesize.ROIplacedintheessenceofthetumor,peritumoralrenalparenchymaandthecontralateralnormalkidneyarea.Byusingintraclasscorrelationcoefficient(ICC)andthenonparametrictestinthestatisticalsoftwareSPSS19.0toan

8、alyzeandstatisticstheconsistencyofthetwoADCvaluesandthedataofeachgroup.Result:35lesionsin