Israel Gary M, Hindman Nicole, Hecht Elizabeth, Krinsky Glenn
Department of Radiology, New York University Medical Center, 560 First Ave., HW202, New York, NY 10016, USA.
AJR Am J Roentgenol. 2005 Jun;184(6):1868-72. doi: 10.2214/ajr.184.6.01841868.
The objective of our study was to determine the reliability of the location of the india ink artifact and signal loss on opposed-phase chemical shift MRI to differentiate angiomyolipomas from solid renal masses and from hemorrhagic-proteinaceous renal cysts.
Twenty-three angiomyolipomas, 24 hemorrhagic-proteinaceous cysts, and 23 solid renal masses (nonangiomyolipomas) were retrospectively evaluated at 1.5 T with chemical shift MRI using TEs of 2.1-2.7 msec (opposed phase) and 4.8-5.3 msec (in phase). Two independent observers reviewed the MR images for signal loss on opposed-phase images and for the presence or absence of india ink artifact. An angiomyolipoma was diagnosed if the india ink artifact was identified at the interface of the mass and the kidney or was present within the renal mass.
Twenty-three (100%) of the 23 angiomyolipomas showed india ink artifact within the mass or at its interface with the kidney, and 18 (78.3%) of the 23 angiomyolipomas showed signal loss on opposed-phase MR images. In 24 (100%) of the 24 hemorrhagic-proteinaceous cysts, india ink artifact was not present within the mass or at its interface with the kidney. No signal loss was seen in hemorrhagic-proteinaceous cysts on opposed-phase MR images. In one (4%) of the 23 solid (nonangiomyolipoma) renal masses, the india ink artifact was identified at the interface of the mass with the kidney, and in two (9%) of the 23 masses, loss of signal was identified on the opposed-phase MR images.
The presence of india artifact at a renal mass-kidney interface or within a renal mass is indicative of angiomyolipoma.
本研究的目的是确定在反相位化学位移磁共振成像（MRI）上，印度墨水伪影的位置及信号丢失对于区分肾血管平滑肌脂肪瘤与实性肾肿块以及出血性含蛋白肾囊肿的可靠性。
回顾性评估23个肾血管平滑肌脂肪瘤、24个出血性含蛋白囊肿和23个实性肾肿块（非肾血管平滑肌脂肪瘤），在1.5T场强下采用化学位移MRI，回波时间（TE）分别为2.1 - 2.7毫秒（反相位）和4.8 - 5.3毫秒（同相位）。两名独立观察者查看MR图像，观察反相位图像上的信号丢失情况以及是否存在印度墨水伪影。如果在肿块与肾脏的界面处或肾肿块内发现印度墨水伪影，则诊断为肾血管平滑肌脂肪瘤。
23个肾血管平滑肌脂肪瘤中的23个（100%）在肿块内或其与肾脏的界面处显示有印度墨水伪影，23个肾血管平滑肌脂肪瘤中的l8个（78.3%）在反相位MR图像上显示信号丢失。24个出血性含蛋白囊肿中的24个（100%）在肿块内或其与肾脏的界面处未出现印度墨水伪影。出血性含蛋白囊肿在反相位MR图像上未见信号丢失。23个实性（非肾血管平滑肌脂肪瘤）肾肿块中有1个（4%）在肿块与肾脏的界面处发现印度墨水伪影，23个肿块中有2个（9%）在反相位MR图像上发现信号丢失。
肾肿块与肾脏界面处或肾肿块内存在印度墨水伪影提示为肾血管平滑肌脂肪瘤。
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