Department of Radiology, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China.
PLoS One. 2013 Nov 12;8(11):e79597. doi: 10.1371/journal.pone.0079597. eCollection 2013.
To retrospectively evaluate whether T2*-weighted imaging can be used to grade clear cell renal cell carcinomas (ccRCC) based on intratumoral susceptibility signals (ISSs).
MR imaging from 37 patients with pathologically-proven ccRCCs was evaluated. ISSs on T2*WI were classified as linear or conglomerated linear structures (type I) and dot-like or patchy foci (type II). Two radiologists assessed the likelihood of the presence of ISS, dominant structure of ISS and ratio of ISS area to tumor area. Results were analyzed by nonparametric Mann-Whitney test.
ISSs were seen in all patients except for four patients with low-grade ccRCCs and two patients with high-grade ccRCCs. There was no significant difference of the likelihood of the presence of ISS between low- and high-grade ccRCCs. More type I ISSs and less type II ISSs were predictive of low-grade tumors, whereas more conspicuity type II ISSs correlated with higher occurrence of high-grade tumors (P<0.05). The ratio of ISS area to tumor area was also significantly higher for the high-grade group (1.27±0.79) than that for the low-grade group (0.81±0.40) (P<0.05).
ISSs on T2*-weighted gradient-echo MR images can help grade ccRCCs before operations.
回顾性评估 T2*-加权成像是否可基于瘤内磁敏感信号（ISSs）用于对透明细胞肾细胞癌（ccRCC）进行分级。
对 37 例经病理证实的 ccRCC 患者的 MR 图像进行评估。T2*WI 上的 ISS 分为线性或聚集线性结构（I 型）和点状或斑片状灶（II 型）。两名放射科医生评估 ISS 的存在可能性、ISS 的主要结构和 ISS 面积与肿瘤面积的比值。结果采用非参数 Mann-Whitney 检验进行分析。
除了 4 例低级别 ccRCC 患者和 2 例高级别 ccRCC 患者外，所有患者均可见 ISS。低级别和高级别 ccRCC 患者的 ISS 存在可能性无显著差异。ISS 更多为 I 型且更少为 II 型提示为低级别肿瘤，而 ISS 更为明显的 II 型提示更高级别肿瘤的发生率更高（P<0.05）。高级别组 ISS 面积与肿瘤面积的比值（1.27±0.79）也显著高于低级别组（0.81±0.40）（P<0.05）。
T2*-加权梯度回波 MR 图像上的 ISS 有助于在术前对 ccRCC 进行分级。
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