传统扩散加权成像与体素内不相干运动在鉴别嫌色性肾细胞癌和肾嗜酸细胞瘤中的比较：一项初步研究
Comparison of conventional diffusion-weighted imaging and intravoxel incoherent motion in differentiating between chromophobe renal cell carcinoma and renal oncocytoma: a preliminary study.
作者信息
Zhu Qingqiang, Sun Jun, Ye Jing, Zhu Wenrong, Chen Wenxin
机构信息
Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou 225001, China.
出版信息
Br J Radiol. 2024 May 29;97(1158):1146-1152. doi: 10.1093/bjr/tqae088.
OBJECTIVE
Quantitative comparison of the diagnostic efficacy of conventional diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM) in differentiating between chromophobe renal cell carcinoma (ChRCC) from renal oncocytoma (RO).
METHODS
A total of 48 patients with renal tumours who had undergone DWI and IVIM were divided into two groups-ChRCC (n = 28) and RO (n = 20) groups, and the apparent diffusion coefficient (ADC), true diffusivity (D), pseudo-diffusion coefficient (D*), perfusion fraction (f) and their diagnostic efficacy were compared between the two groups.
RESULTS
The D* values were higher in the ChRCCs group compared to the RO groups (0.019 ± 0.003 mm2/s vs 0.008 ± 0.002 mm2/s, P < .05). Moreover, the ADC, D and f values were higher in ROs compared to ChRCCs (0.61 ± 0.08 × 10-3 mm2/s vs 0.51 ± 0.06 × 10-3 mm2/s, 1.02 ± 0.15 × 10-3 mm2/s vs 0.86 ± 0.07 × 10-3 mm2/s, 0.41 ± 0.05 vs 0.28 ± 0.02, P < .05). The areas of the ADC, D, D* and f values under the ROC curves in differentiating ChRCCs from ROs were 0.713, 0.839, 0.856 and 0.906, respectively. The cut-off values of ADC, D, D* and f were 0.54, 0.91, 0.013 and 0.31, respectively. The AUC, sensitivity, specificity and accuracy of the f values were 0.906, 89.3%, 80.0% and 89.6%, respectively. For pairwise comparisons of ROC curves and diagnostic efficacy, IVIM parameters, that is, D, D* and f offered better diagnostic accuracy than ADC in differentiating ChRCCs from ROs (P = .013, .016, and .008) with f having the highest diagnostic accuracy.
CONCLUSION
IVIM parameters presented better performance than ADC in differentiating ChRCCs from ROs.
ADVANCES IN KNOWLEDGE
(1) D* values of ChRCCs were higher, while ADC, D and f values were lower than those of RO tumours. (2) f values had the highest diagnostic efficacy in differentiating ChRCC from RO. (3) IVIM parameters, that is, D, D* and f offered better diagnostic accuracy than ADC in differentiating ChRCC from RO (P=.013, .016, and .008).
目的
定量比较常规扩散加权成像（DWI）和体素内不相干运动（IVIM）在鉴别嫌色性肾细胞癌（ChRCC）与肾嗜酸细胞瘤（RO）中的诊断效能。
方法
将48例行DWI和IVIM检查的肾肿瘤患者分为两组——ChRCC组（n = 28）和RO组（n = 20），比较两组的表观扩散系数（ADC）、真实扩散系数（D）、伪扩散系数（D*）、灌注分数（f）及其诊断效能。
结果
ChRCC组的D值高于RO组（0.019±0.003 mm²/s对0.008±0.002 mm²/s，P < 0.05）。此外，RO组的ADC、D和f值高于ChRCC组（0.61±0.08×10⁻³ mm²/s对0.51±0.06×10⁻³ mm²/s，1.02±0.15×10⁻³ mm²/s对0.86±0.07×10⁻³ mm²/s，0.41±0.05对0.28±0.02，P < 0.05）。在鉴别ChRCC与RO时，ADC、D、D和f值的ROC曲线下面积分别为0.713、0.839、0.856和0.906。ADC、D、D和f的截断值分别为0.54、0.91、0.013和0.31。f值的AUC、敏感性、特异性和准确性分别为0.906、89.3%、80.0%和89.6%。对于ROC曲线和诊断效能的两两比较，IVIM参数，即D、D和f在鉴别ChRCC与RO时比ADC具有更好的诊断准确性（P = 0.013、0.016和0.008），其中f的诊断准确性最高。
结论
在鉴别ChRCC与RO时，IVIM参数比ADC表现更好。
知识进展
（1）ChRCC的D值较高，而ADC、D和f值低于RO肿瘤。（2）f值在鉴别ChRCC与RO时具有最高的诊断效能。（3）IVIM参数，即D、D和f在鉴别ChRCC与RO时比ADC具有更好的诊断准确性（P = 0.013、0.016和0.008）。
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