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肾细胞癌还是嗜酸细胞瘤?扩散加权磁共振成像对肾肿块鉴别诊断的作用。

Renal Cell Carcinoma or Oncocytoma? The Contribution of Diffusion-Weighted Magnetic Resonance Imaging to the Differential Diagnosis of Renal Masses.

机构信息

Radiology Department, Medical Park University, Istanbul 34262, Turkey.

Radiology Department, Oncology Research Hospital, University of Health Sciences, Ankara 06610, Turkey.

出版信息

Medicina (Kaunas). 2022 Feb 1;58(2):221. doi: 10.3390/medicina58020221.

Abstract

: Renal Cell Carcinoma (RCC) accounts for 85% and oncocytomas constitute 3-7% of solid renal masses. Oncocytomas can be confused, especially with hypovascular RCC. The purpose of this research was to evaluate the contribution of diffusion-weighted imaging (DWI) and contrast-enhanced MRI sequences in the differential diagnosis of RCC and oncocytoma : 465 patients with the diagnosis of RCC and 45 patients diagnosed with oncocytoma were retrospectively reviewed between 2009 to 2020. All MRI acquisitions were handled by a 1.5 T device (Achieva, Philips Healthcare, Best, The Netherlands) and all images were evaluated by the consensus of two radiologists with 10-15 years' experience. The SPSS package program version 15.0 software was used for statistical analysis of the study. Chi-square test, Mann-Whitney U test or the Kruskal-Wallis tests were used in the statistical analysis. A receiver operating characteristic (ROC) curve was used to calculate the cut-off values : The results were evaluated with a 95% confidence interval and a significance threshold of < 0.05. ADC values ( < 0.001) and enhancement index ( < 0.01) were significantly lower in the RCC group than the oncocytoma group. : DWI might become an alternative technique to the contrast-enhanced MRI in patients with contrast agent nephropathy or with a high risk of nephrogenic systemic fibrosis, calculation of CI of the oncocytoma and RCCs in the contrast-enhanced acquisitions would contribute to the differential diagnosis.

摘要

肾细胞癌 (RCC) 占 85%,而嗜酸细胞瘤构成 3-7%的实体性肾肿块。嗜酸细胞瘤可能会被混淆,特别是与低血供 RCC 混淆。本研究旨在评估扩散加权成像 (DWI) 和对比增强 MRI 序列在 RCC 和嗜酸细胞瘤鉴别诊断中的作用:2009 年至 2020 年间回顾性分析了 465 例 RCC 诊断患者和 45 例嗜酸细胞瘤诊断患者。所有 MRI 采集均由 1.5T 设备 (Achieva,Philips Healthcare,Best,荷兰) 处理,所有图像均由两位具有 10-15 年经验的放射科医生共识评估。使用 SPSS 包程序版本 15.0 软件进行研究的统计分析。卡方检验、Mann-Whitney U 检验或 Kruskal-Wallis 检验用于统计分析。使用受试者工作特征 (ROC) 曲线计算截断值:使用 95%置信区间和 < 0.05 的显著性阈值评估结果。RCC 组的 ADC 值(<0.001)和增强指数(<0.01)显著低于嗜酸细胞瘤组。在造影剂肾病或存在高风险发生肾源性系统性纤维化的患者中,DWI 可能成为对比增强 MRI 的替代技术,计算对比增强采集的嗜酸细胞瘤和 RCC 的 CI 将有助于鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248a/8878185/e36ee083ebf4/medicina-58-00221-g001.jpg

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