Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China.
Br J Radiol. 2022 May 1;95(1133):20210485. doi: 10.1259/bjr.20210485. Epub 2022 Feb 9.
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).
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.
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).
IVIM parameters have better performance than ADC in differentiating ccRCC grading, given an adequate SNR of IVIM images.
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。
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。
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）。
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。
