Feng Qiang, Ma Zhijun, Zhang Sujuan, Wu Jianlin
Department of Radiology, Affiliated Yidu Central Hospital, Weifang Medical University, Weifang, 262500 Shandong People's Republic of China.
Affiliated zhongshan Hospital, Dalian University, No. 6 jiefang Road, Zhongshan District, Dalian, 116001 Liaoning People's Republic of China.
Springerplus. 2016 Jan 4;5:12. doi: 10.1186/s40064-015-1627-x. eCollection 2016.
To investigate the value of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in differentiating clear-cell renal cell carcinoma (CCRCC) from low-fat renal angiomyolipomas (RAML), and to obtain the optimal b value. Fifty patients, including 30 cases of CCRCC and 20 cases of low-fat RAML, were retrospectively recruited to participate in this study. Before renal nephrectomy, all subjects underwent functional magnetic resonance imaging. For diffusion tensor imaging (DTI), a respiratory-triggered coronal echo planar imaging sequence was performed with three groups of different b values (0 and 400, 600, and 800). The ADC and FA of kidneys were analyzed and compared between different b values using analysis of variance. Receiver operation characteristic analysis was computed to assess the diagnostic performance of ADC and FA in differentiating low-fat RAML from CCRCC and to determine the optimal b values. With either CCRCC or low-fat RAML, the ADC values decreased with increased b values and significant differences were observed (F = 11.34, 23.15, P < 0.05), while the FA values were not significantly different (F = 0.28, 2.80, P > 0.05). The statistical differences in ADC, and the FA values for CCRCC and low-fat RAML were significantly different (P < 0.05). When the b value was 0.800 s/mm(2), the cutoff FA value for differentiating CCRCC from low-fat RAML was 0.254 × 10.3 mm(2)/s, and had a sensitivity of 100 %, and a specificity of 73.3 %. MR-DTI can be used to differentiate CCRCC from low-fat RAML.
探讨表观扩散系数（ADC）和各向异性分数（FA）在鉴别透明细胞肾细胞癌（CCRCC）与低脂肾血管平滑肌脂肪瘤（RAML）中的价值，并获取最佳b值。回顾性纳入50例患者，其中包括30例CCRCC和20例低脂RAML患者参与本研究。在肾切除术前，所有受试者均接受功能磁共振成像检查。对于扩散张量成像（DTI），采用呼吸触发冠状面回波平面成像序列，设置三组不同的b值（0、400、600和800）。采用方差分析对不同b值下肾脏的ADC和FA进行分析和比较。计算受试者工作特征分析，以评估ADC和FA在鉴别低脂RAML与CCRCC中的诊断性能，并确定最佳b值。无论是CCRCC还是低脂RAML，ADC值均随b值增加而降低，差异有统计学意义（F = 11.34，23.15，P < 0.05），而FA值差异无统计学意义（F = 0.28，2.80，P > 0.05）。CCRCC和低脂RAML的ADC及FA值的统计学差异有显著性（P < 0.05）。当b值为0.800 s/mm²时，鉴别CCRCC与低脂RAML的FA临界值为0.254×10.3 mm²/s，灵敏度为100%，特异度为73.3%。磁共振扩散张量成像可用于鉴别CCRCC与低脂RAML。
