Department of Medical Imaging, Subei People's Hospital, Medical School of Yangzhou University, Yangzhou, China.
MR Research China, GE Healthcare, Beijing 100176, China., Beijing, China.
Br J Radiol. 2021 Jun 1;94(1122):20201374. doi: 10.1259/bjr.20201374. Epub 2021 May 14.
To explore the feasibility of diffusion kurtosis imaging (DKI) in differentiating different types of renal cell carcinoma (RCC).
36 patients with clear cell RCC (CCRCC, low-grade, = 20 and high-grade, = 16), 19 with papillary RCC, 11 with chromophobe RCC, and 9 with collecting duct carcinoma (CDC) were examined with DKI technique. b values of 0, 500 and 1000 s/mm were adopted. The DKI parameters, mean diffusivity (MD), mean kurtosis (MK), kurtosis anisotropy (KA), radial kurtosis (RK) and signa-to-noise ration (SNR) of DKI images at different b values were used.
The mean SNRs of DKI images at = 0, 500 and 1000 s/mm were 32.8, 14.2 and 9.18, respectively. For MD parameter, a significant higher value was shown in CCRCC than those of papillary RCC, chromophobe RCC and CDC ( < 0.05). In addition, both chromophobe RCC and CDC have larger MD values than papillary RCC ( < 0.05), however, there was no significant differences between chromophobe RCC and CDC ( > 0.05). For MK, KA and RK parameters, a significant higher value was shown in papillary RCC than those of CCRCC, chromophobe RCC and CDC ( < 0.05). Moreover, both chromophobe RCC and CDC have significantly larger values of MK, KA and RK than CCRCC ( < 0.05).
Our preliminary study demonstrated significant differences in the DKI parameters between the subtypes of RCCs, given an adequate SNR of DKI images.
1.The MD value is the best parameter to distinguish CCRCC from other RCCs.2.The MK, KA and RK values are the best parameters to distinguish papillary RCC from other RCCs.3.DKI is able to provide images with sufficient SNRs in kidney disease.
探讨扩散峰度成像(DKI)在鉴别不同类型肾细胞癌(RCC)中的可行性。
对 36 例透明细胞 RCC(CCRCC,低级别=20 例,高级别=16 例)、19 例乳头状 RCC、11 例嫌色细胞 RCC 和 9 例集合管癌(CDC)患者进行 DKI 技术检查。采用 b 值为 0、500 和 1000 s/mm。分析不同 b 值下 DKI 图像的各参数,包括平均扩散系数(MD)、平均峰度(MK)、峰度各向异性(KA)、径向峰度(RK)和信噪比(SNR)。
=0、500 和 1000 s/mm 时 DKI 图像的平均 SNR 分别为 32.8、14.2 和 9.18。MD 参数在 CCRCC 中明显高于乳头状 RCC、嫌色细胞 RCC 和 CDC(<0.05)。此外,嫌色细胞 RCC 和 CDC 的 MD 值均大于乳头状 RCC(<0.05),但两者之间无显著差异(>0.05)。MK、KA 和 RK 参数在乳头状 RCC 中明显高于 CCRCC、嫌色细胞 RCC 和 CDC(<0.05)。此外,嫌色细胞 RCC 和 CDC 的 MK、KA 和 RK 值明显大于 CCRCC(<0.05)。
在获得足够 DKI 图像 SNR 的情况下,本研究初步表明 DKI 参数在 RCC 各亚型之间存在显著差异。
1.MD 值是鉴别 CCRCC 与其他 RCC 的最佳参数。2.MK、KA 和 RK 值是鉴别乳头状 RCC 与其他 RCC 的最佳参数。3.DKI 能够在肾脏疾病中提供具有足够 SNR 的图像。