增强磁共振成像和扩散加权成像鉴别肾脏良、恶性病变的诊断效能
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摘要
目的分析增强磁共振成像(DCE-MRI)与扩散加权成像(DWI)鉴别、诊断肾脏良、恶性病变的价值。方法选择2016年8月至2018年8月我院收治的68例肾脏占位性病变患者(良性病变41例、恶性病变27例)作为研究对象,并选择同期在我院进行健康体检的30名健康人作为对照组,均行常规MRI扫描、DCE-MRI扫描和DWI扫描。比较良性病变组、恶性病变组和对照组的表观扩散系数(ADC)、相对表观扩散系数(r ADC)、容量转移常数(K~(trans))、血管外细胞外间隙容积(Ve)及速率常数(K_ep),并采用受试者工作特性曲线(ROC)评价以上指标诊断肾脏占位性病变良恶性的效能。结果恶性病变组的ADC显著低于良性病变组和对照组(P<0.05)。三组的r ADC比较,差异无统计学意义(P>0.05)。恶性病变组的K~(trans)和K_ep显著高于对照组和良性病变组(P<0.05);对照组和良性病变组的K~(trans)和K_ep比较无显著差异(P>0.05);良性病变组和恶性病变组的Ve比较无显著差异(P>0.05),但均显著低于对照组(P<0.05)。ADC、K~(trans)、K_ep及联合诊断肾脏良、恶性病变的AUC分别为0.877(95%CI:0.819～0.935)、0.878(95%CI:0.822～0.933)、0.768(95%CI:0.697～0.839)和0.935(95%CI:0.894～0.976),灵敏度和特异度分别为78.9%和92.5%、90.8%和77.3%、64.5%和75.0%、98.7%和90.2%。结论DCE-MRI和DWI均可用于肾脏良、恶性病变的鉴别,ADC、K~(trans)、K_ep具有较好的诊断效能,三者联合诊断肾脏占位性病变良恶性的效果更好。
Objective To analyze the value of contrast-enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in differentiating benign and malignant renal lesions. Methods Sixty-eight cases of renal spaceoccupying lesions(41 cases of benign lesions and 27 cases of malignant lesions) admitted in our hospital from August 2016 to August 2018 were selected as the study subjects, and 30 healthy persons who underwent physical examination in our hospital during the same period were selected as the control group. All patients underwent routine MRI scan, DCE-MRI scan and DWI scan. The apparent diffusion coefficient(ADC), relative apparent diffusion coefficient(rADC), volume transfer constant(K~(trans)), extracellular space volume(Ve) and rate constant(K_ep) of benign lesion group, malignant lesion group and the control group were compared. The performance of the above indicators in the diagnosis of benign and malignant renal space-occupying lesions was evaluated by receiver operating characteristic curve(ROC). Results The ADC of the malignant lesion group was significantly lower than that of the benign lesion group and the control group(P<0.05).There was no significant difference in rADC among the three groups(P>0.05). The K~(trans)and (K_ep)in the malignant lesion group were significantly higher than those in the control group and the benign lesion group(P<0.05), while there were no significant differences in K~(trans)and (K_ep)between the control group and the benign lesion group(P >0.05). There was no significant difference in Vebetween the benign lesion group and the malignant lesion group(P>0.05), but that in the benign lesion group and the malignant lesion group was significantly lower than in the control group(P<0.05). The AUC for ADC,K~(trans), (K_ep)and combined diagnosis of benign and malignant renal lesions were 0.877(95%CI: 0.819-0.935), 0.878(95%CI:0.822-0.933), 0.768(95% CI: 0.697-0.839) and 0.935(95% CI: 0.894-0.976) respectively, and the sensitivity and specificity were 78.9% and 92.5%, 90.8% and 77.3%, 64.5% and 75.0%, 98.7% and 90.2% respectively. Conclusion DCE-MRI and DWI can be used to differentiate benign and malignant renal lesions. ADC, K~(trans)and (K_ep)have better diagnostic efficacy, and the combination of them is more effective.
Objective To analyze the value of contrast-enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in differentiating benign and malignant renal lesions. Methods Sixty-eight cases of renal spaceoccupying lesions(41 cases of benign lesions and 27 cases of malignant lesions) admitted in our hospital from August 2016 to August 2018 were selected as the study subjects, and 30 healthy persons who underwent physical examination in our hospital during the same period were selected as the control group. All patients underwent routine MRI scan, DCE-MRI scan and DWI scan. The apparent diffusion coefficient(ADC), relative apparent diffusion coefficient(rADC), volume transfer constant(K~(trans)), extracellular space volume(Ve) and rate constant(K_ep) of benign lesion group, malignant lesion group and the control group were compared. The performance of the above indicators in the diagnosis of benign and malignant renal space-occupying lesions was evaluated by receiver operating characteristic curve(ROC). Results The ADC of the malignant lesion group was significantly lower than that of the benign lesion group and the control group(P<0.05).There was no significant difference in rADC among the three groups(P>0.05). The K~(trans)and (K_ep)in the malignant lesion group were significantly higher than those in the control group and the benign lesion group(P<0.05), while there were no significant differences in K~(trans)and (K_ep)between the control group and the benign lesion group(P >0.05). There was no significant difference in Vebetween the benign lesion group and the malignant lesion group(P>0.05), but that in the benign lesion group and the malignant lesion group was significantly lower than in the control group(P<0.05). The AUC for ADC,K~(trans), (K_ep)and combined diagnosis of benign and malignant renal lesions were 0.877(95%CI: 0.819-0.935), 0.878(95%CI:0.822-0.933), 0.768(95% CI: 0.697-0.839) and 0.935(95% CI: 0.894-0.976) respectively, and the sensitivity and specificity were 78.9% and 92.5%, 90.8% and 77.3%, 64.5% and 75.0%, 98.7% and 90.2% respectively. Conclusion DCE-MRI and DWI can be used to differentiate benign and malignant renal lesions. ADC, K~(trans)and (K_ep)have better diagnostic efficacy, and the combination of them is more effective.
引文
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