动脉自旋标记磁共振成像用于检测肾细胞癌的假包膜缺损并预测肾包膜侵犯

Arterial spin labelling MRI for detecting pseudocapsule defects and predicting renal capsule invasion in renal cell carcinoma.

作者信息

Zhang H, Wu Y, Xue W, Zuo P, Oesingmann N, Gan Q, Huang Z, Wu M, Hu F, Kuang M, Song B

机构信息

Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan 610041, China.

School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166, Liutai Avenue, Wenjiang District, Chengdu 611137, China.

出版信息

Clin Radiol. 2017 Nov;72(11):936-943. doi: 10.1016/j.crad.2017.06.003. Epub 2017 Jun 30.

DOI:10.1016/j.crad.2017.06.003

PMID:28673449

Abstract

AIM

To evaluate prospectively the performance of combining morphological and arterial spin labelling (ASL) magnetic resonance imaging (MRI) for detecting pseudocapsule defects in renal cell carcinoma (RCC), and to predict renal capsule invasion confirmed histopathologically.

MATERIALS AND METHODS

Twenty consecutive patients with suspicious renal tumours underwent MRI. Renal ASL imaging was performed and renal blood flow was measured quantitatively. The diagnostic performance of T2-weighted images alone, and a combination of T2-weighted and ASL images for predicting renal capsule invasion were assessed.

RESULTS

Twenty renal lesions were evaluated in 20 patients. All lesions were clear cell RCCs (ccRCCs) confirmed at post-surgical histopathology. Fifteen ccRCCs showed pseudocapsule defects on T2-weighted images, of which 12 cases showed existing blood flow in defect areas on perfusion images. To predict renal capsule invasion, the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 71.4%, 86.7%, 100%, respectively, for T2-weighted images alone, and 92.3%, 100%, 100%, 87.5%, respectively, for the combination of T2-weighted and ASL images.

CONCLUSION

ASL images can reflect the perfusion of pseudocapsule defects and as such, the combination of T2-weighted and ASL images produces promising diagnostic accuracy for predicting renal capsule invasion.

摘要

目的

前瞻性评估形态学与动脉自旋标记（ASL）磁共振成像（MRI）相结合在检测肾细胞癌（RCC）假包膜缺损方面的性能，并预测经组织病理学证实的肾包膜侵犯情况。

材料与方法

连续20例患有可疑肾肿瘤的患者接受了MRI检查。进行了肾脏ASL成像并定量测量了肾血流量。评估了单独的T2加权图像以及T2加权图像与ASL图像相结合在预测肾包膜侵犯方面的诊断性能。

结果

对20例患者的20个肾脏病变进行了评估。所有病变在手术后组织病理学检查中均确诊为透明细胞肾细胞癌（ccRCC）。15个ccRCC在T2加权图像上显示假包膜缺损，其中12例在灌注图像上显示缺损区域存在血流。为预测肾包膜侵犯，单独的T2加权图像的敏感性、特异性、阳性预测值和阴性预测值分别为100%、71.4%、86.7%、100%，T2加权图像与ASL图像相结合时分别为92.3%、100%、100%、87.5%。