常规弥散加权成像与体素内不相干运动在评估透明细胞肾细胞癌病理分级中的对比研究。
Comparative study of conventional diffusion-weighted imaging and introvoxel incoherent motion in assessment of pathological grade of clear cell renal cell carcinoma.
机构信息
Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China.
出版信息
Br J Radiol. 2022 May 1;95(1133):20210485. doi: 10.1259/bjr.20210485. Epub 2022 Feb 9.
OBJECTIVE
To quantitatively compare the diagnostic values of conventional diffusion-weighted imaging (DWI) and introvoxel incoherent motion (IVIM) analysis of microstructural differences for clear cell renal cell carcinoma (ccRCC).
METHODS
Multiple b value DWIs and IVIMs were performed in patients with 146 ccRCCs, 42 with Grade Ⅰ, 46 with Grade Ⅱ, 28 with Grade Ⅲ and 30 with Grade Ⅳ. These tumours were divided into low (Ⅰ+Ⅱ, = 88) and high grades (Ⅲ+Ⅳ, = 58). The diagnostic efficacy of various diffusion parameters for predicting ccRCC grades was compared.
RESULTS
The mean signal-to-noise ratios (SNRs) of IVIM images at = 0, 800 and 1500 s/mm were 31.9, 12.3 and 8.4, respectively. The apparent diffusion coefficient (ADC), D and D* values correlated negatively with ccRCC grading ( = -0.786,-0.913, -0879, < 0.05). f values correlated positively with ccRCC grading ( = 0.811, < 0.05). The ADC, D and D* values were higher for Grade Ⅱ ccRCC than that of Grade Ⅲ ccRCC ( < 005), however, f values were higher for Grade Ⅲ ccRCC than that of Grade Ⅱ ccRCC ( < 005). Receiver operating characteristic curve analyses showed that D values had the highest diagnostic efficacy in differentiating low/high and Ⅱ/Ⅲ ccRCC grading. The area under the curve, sensitivity, specificity and accuracy of the D values were 0.963, 0.960; 90.9%, 89.1%; 81.0%,78.6 and 89.0%, 87.8%, respectively. For pairwise comparisons of receiver operating characteristic curves and diagnostic efficacy, ADC was worse than IVIM (all < 0.05).
CONCLUSION
IVIM parameters have better performance than ADC in differentiating ccRCC grading, given an adequate SNR of IVIM images.
ADVANCES IN KNOWLEDGE
- D values had the highest diagnostic efficacy in differentiating low/high and Ⅱ/Ⅲ ccRCC grading. 2. IVIM parameters have better performance than ADC in differentiating ccRCC grading, given an adequate SNR of IVIM images. 3. The ADC, D and D* values correlated negatively with ccRCC grading, however, f values correlated positively with ccRCC grading.
目的
定量比较常规弥散加权成像（DWI）和体素内不相干运动（IVIM）分析在透明细胞肾细胞癌（ccRCC）微观结构差异方面的诊断价值。
方法
对 146 例 ccRCC 患者进行了多个 b 值 DWI 和 IVIM 检查，其中 42 例为Ⅰ级，46 例为Ⅱ级，28 例为Ⅲ级，30 例为Ⅳ级。这些肿瘤分为低级别（Ⅰ+Ⅱ，n=88）和高级别（Ⅲ+Ⅳ，n=58）。比较了各种扩散参数预测 ccRCC 分级的诊断效能。
结果
IVIM 图像在 = 0、800 和 1500 s/mm 时的平均信噪比（SNR）分别为 31.9、12.3 和 8.4。表观扩散系数（ADC）、D 值和 D值与 ccRCC 分级呈负相关（ = -0.786、-0.913、-0.879， < 0.05）。f 值与 ccRCC 分级呈正相关（ = 0.811， < 0.05）。Ⅱ级 ccRCC 的 ADC、D 值和 D值均高于Ⅲ级 ccRCC（ < 0.05），而Ⅲ级 ccRCC 的 f 值高于Ⅱ级 ccRCC（ < 0.05）。受试者工作特征曲线分析显示，D 值在区分低级别/高级别和Ⅱ/Ⅲ级 ccRCC 分级方面具有最高的诊断效能。D 值的曲线下面积、敏感性、特异性和准确性分别为 0.963、0.960、90.9%、89.1%、81.0%、78.6%和 89.0%、87.8%。对于受试者工作特征曲线和诊断效能的两两比较，ADC 劣于 IVIM（均 < 0.05）。
结论
在获得足够的 IVIM 图像 SNR 的情况下，IVIM 参数在区分 ccRCC 分级方面的表现优于 ADC。
知识进展
- D 值在区分低级别/高级别和Ⅱ/Ⅲ级 ccRCC 分级方面具有最高的诊断效能。2. 在获得足够的 IVIM 图像 SNR 的情况下，IVIM 参数在区分 ccRCC 分级方面的表现优于 ADC。3. ADC、D 值和 D*值与 ccRCC 分级呈负相关，然而，f 值与 ccRCC 分级呈正相关。
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