单指数、双指数和三指数扩散 MRI 建模用于肾脏实性肿块，并与组织病理学发现进行比较。
Mono, bi- and tri-exponential diffusion MRI modelling for renal solid masses and comparison with histopathological findings.
机构信息
Magnetic Detection & Imaging, University of Twente, Drienerlolaan 5, 7522 NB, Enschede, Netherlands.
Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands.
出版信息
Cancer Imaging. 2018 Nov 26;18(1):44. doi: 10.1186/s40644-018-0178-0.
PURPOSE
To compare diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM), and tri-exponential models of the diffusion magnetic resonance imaging (MRI) signal for the characterization of renal lesions in relationship to histopathological findings.
METHODS
Sixteen patients planned to undergo nephrectomy for kidney tumour were scanned before surgery at 3 T magnetic resonance imaging (MRI), with T-weighted imaging, DTI and diffusion weighted imaging (DWI) using ten b-values. DTI parameters (mean diffusivity [MD] and fractional anisotropy [FA]) were obtained by iterative weighted linear least squared fitting of the DTI data and bi-, and tri-exponential fit parameters (D, fand D, ff) using a nonlinear fit of the multiple b-value DWI data. Average parameters were calculated for regions of interest, selecting the lesions and healthy kidney tissue. Tumour type and specificities were determined after surgery by histological examination. Mean parameter values of healthy tissue and solid lesions were compared using a Wilcoxon-signed ranked test and MANOVA.
RESULTS
Thirteen solid lesions (nine clear cell carcinomas, two papillary renal cell carcinoma, one haemangioma and one oncocytoma) and four cysts were included. The mean MD of solid lesions are significantly (p < 0.05) lower than healthy cortex and medulla, (1.94 ± 0.3210 mm/s versus 2.16 ± 0.1210 mm/s and 2.21 ± 0.1410 mm/s, respectively) whereas f is significantly higher (7.30 ± 3.29% versus 4.14 ± 1.92% and 4.57 ± 1.74%) and f is significantly lower (18.7 ± 5.02% versus 28.8 ± 5.09% and 26.4 ± 6.65%). Diffusion coefficients were high (≥2.010 mm/s for MD, 1.9010 mm/s for D and 1.610 mm/s for D) in cc-RCCs with cystic structures and/or haemorrhaging and low (≤1.8010 mm/s for MD, 1.4010 mm/s for D and 1.05*10 mm/s for D) in tumours with necrosis or sarcomatoid differentiation.
CONCLUSION
Parameters derived from a two- or three-component fit of the diffusion signal are sensitive to histopathological features of kidney lesions.
目的
比较体素内不相干运动（IVIM）和磁共振扩散加权成像（DWI）的三指数模型与扩散张量成像（DTI），以评估其在肾病变特征与组织病理学发现相关性中的作用。
方法
16 例计划接受肾肿瘤切除术的患者在 3T 磁共振成像（MRI）术前进行扫描，包括 T1 加权成像、DTI 和 DWI，使用 10 个 b 值。DTI 参数（平均弥散度 [MD] 和各向异性分数 [FA]）通过迭代加权线性最小二乘法拟合 DTI 数据获得，双指数和三指数拟合参数（D、f 和 D, ff）通过非线性拟合多 b 值 DWI 数据获得。在感兴趣区域中计算参数的平均值，选择病变和健康肾组织。术后通过组织学检查确定肿瘤类型和特征。使用 Wilcoxon 符号秩检验和 MANOVA 比较健康组织和实性病变的平均参数值。
结果
纳入 13 例实性病变（9 例透明细胞癌、2 例乳头状肾细胞癌、1 例血管平滑肌脂肪瘤和 1 例嗜酸细胞瘤）和 4 例囊肿。实性病变的 MD 值明显低于健康皮质和髓质（1.94±0.3210mm/s比 2.16±0.1210mm/s 和 2.21±0.1410mm/s，p<0.05），f 值明显高于（7.30±3.29%比 4.14±1.92%和 4.57±1.74%，p<0.05），f 值明显低于（18.7±5.02%比 28.8±5.09%和 26.4±6.65%，p<0.05）。具有囊性结构和/或出血的 cc-RCCs 中扩散系数较高（MD≥2.010mm/s，D≥1.9010mm/s，D≥1.610mm/s），而具有坏死或肉瘤样分化的肿瘤中扩散系数较低（MD≤1.8010mm/s，D≤1.4010mm/s，D≤1.05*10mm/s）。
结论
来源于扩散信号双指数或三指数拟合的参数对肾病变的组织病理学特征敏感。
Zotero 插件