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定量纵向弛豫时间与多期增强MRI评价肾透明细胞癌病理分级的价值对比 |
谭沁璇,丁玉芹,戴辰晨,唐启瑛,曾蒙苏,周建军
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1.复旦大学附属中山医院放射科, 上海市影像医学研究所, 复旦大学上海医学院影像学系, 上海 200032;2.复旦大学附属中山医院厦门医院放射科, 厦门 361015
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摘要: |
目的: 探讨定量纵向弛豫时间图(T1 mapping)和多期增强MRI鉴别高、低级别肾透明细胞癌(clear cell renal cell carcinoma,ccRCC)的价值。方法: 回顾性分析经病理证实的94例ccRCC患者的资料,术前均行T1 mapping和多期增强MRI检查。根据国际泌尿病理学会(International Society of Urological Pathology,ISUP)分级标准,Ⅰ~Ⅱ级64例(低级别组),Ⅲ~Ⅳ级30例(高级别组)。比较两组之间的皮髓质期和肾实质期的强化率,平扫和增强后T1值及T1值下降率。采用受试者工作特征曲线(receiver operating characteristic,ROC)分析两种方法评估ccRCC的价值。结果: 高级别组ccRCC增强后皮髓质期及肾实质期的强化率均低于低级别组,但差异均无统计学意义。高级别组ccRCC增强后的T1值高于低级别组,T1值下降率低于低级别组,差异均有统计学意义(P<0.001)。增强后T1值和T1值下降率鉴别高低级别ccRCC的ROC曲线下面积分别为0.855和0.828。结论: 定量T1 mapping在鉴别高、低级别ccRCC方面优于常规多期增强MRI扫描。 |
关键词: 肾细胞癌 细胞核分级 定量分析 纵向弛豫时间 |
DOI:10.12025/j.issn.1008-6358.2020.20192028 |
分类号:R737.11 |
基金项目:福建省科技计划项目(2019-CXB-33). |
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Comparison of quantitative T1 mapping and multi-phase enhanced MRI in evaluating pathological grading of clear cell renal cell carcinoma |
TAN Qin-xuan1,2,3, DING Yu-qin1,2,3, DAI Chen-chen1,2,3, TANG Qi-ying4, ZENG Meng-su1,2,3, ZHOU Jian-jun1,2,3,4
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1.Department of Radiology, Zhongshan Hospital, Fudan University;2.Shanghai Institute of Medical Imaging;3.Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China;4.Department of Radiology, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen 361015, Fujian, China
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Abstract: |
Objective: To compare the value of quantitative T1 mapping and multi-phase enhanced MRI in differentiating between low- and high-grade clear cell renal cell carcinoma (ccRCC). Methods: Clinical data of ninety-four patients with ccRCC approved by pathological examination were respectively analyzed. All patients underwent T1 mapping and multi-phase enhanced MRI examination before operation. According to the International Society of Urological Pathology (ISUP) classification criteria, 64 patients were grade Ⅰ-Ⅱ (low-grade group), and 30 patients were grade Ⅲ-Ⅳ (high-grade group). The enhancement rate of corticomedullary phase and nephrographic phase, T1 values of pre-and post-contrast imaging as well as the T1 reduction rate were compared between the two groups. The receiver operating characteristic (ROC) analysis was used for the evaluation. Results: The enhancement rate of ccRCC in the high-grade group in corticomedullary phase and nephrographic phase were lower than those in the low-grade group, but there was no significant difference between the two groups. The post-contrast T1 value increased and T1 reduction rate decreased in the high-grade group compared with those in the low-grade group (P<0.001). The areas under the ROC curves for the post-contrast T1 and T1 reduction rate values to distinguish low- and high-grade ccRCC were 0.855 and 0.828, respectively. Conclusions: Quantitative T1 mapping is superior to conventional multi-phasic enhanced MRI scanning in differentiating between low- and high-grade ccRCC. |
Key words: renal cell carcinoma nuclear grades quantitative analysis T1 mapping |