Application of Magnetic Resonance T2WI Signal Intensity Combined with DWI-ADC Value in the Differential Diagnosis of Clear Cell Renal Cell Carcinoma and Fat-poor Renal Angiomyolipoma
Objective To analyze the significance of magnetic resonance imaging(MRI)T2 weighted images(T2WI)signal intensity(SI-T2)ratio combined with diffusion weighted imaging(DWI)-apparent diffusion coefficient(ADC)ratio in the differential diagnosis of clear cell renal cell carcinoma(ccRCC)and fat-poor renal angiomyolipoma(fpAML).Methods The clinical data of 62 patients with ccRCC(ccRCC group)and 45 patients with fpAML(fpAML group)admitted to our hospital from March 2021 to March 2024 who received preoperative routine MRI examination and were confirmed by surgical specimen pathology were retrospectively analyzed.All patients underwent MRI plain scan and DWI sequential scan before surgery,and MRI signs were recorded.At the same time,SI-T2 ratio(tumor SI-T2/ipsilateral normal renal cortex SI-T2)and DWI-ADC ratio(tumor DWI-ADC value/ipsilateral normal renal cortex DWI-ADC value)were measured and calculated.Receive operating characteristic(ROC)was used to evaluate the efficacy of MRI SI-T2 ratio and DWI-ADC ratio in the differential diagnosis of ccRCC and fpAML alone and in combination.Results The maximum focal diameter of 62 ccRCC patients was 1.20～6.20(2.90±0.58)cm;36 cases(58.06％)had lesions with a maximum diameter of less than 4.00 cm,all of which were solid masses,26 cases(41.94％)had a maximum diameter of ≥ 4.00 cm,mainly presenting as solid cystic masses.The solid portion of ccRCC showed isolow signal on T1WI,slightly high or mixed isohigh signal on T2WI,and slightly high signal on DWI.The maximum focal diameter of 45 fpAML patients was 0.85～4.30(1.80±0.36)cm;All lesions were solid masses with slightly uneven signals.T1WI showed equal low signal,T2WI showed equal or slightly low signal,and DWI showed slightly high signal.The maximum lesion diameter in ccRCC group was significantly higher than that in fpAML group(P＜0.001).The MRI Sl-T2 ratio in ccRCC group was significantly higher than that in fpAML group(P＜0.001),and the DWI-ADC ratio was significantly lower than that in fpAML group(P＜0.05).ROC curve analysis showed that MRI SI-T2 ratio and DWI-ADC ratio were effective in differential diagnosis of ccRCC and fpAML,and the area under the curve were 0.747 and 0.809,respectively;The area under the curve for the combined differential diagnosis of ccRCC and fpAML was 0.890.Conclusion The MRI Sl-T2 ratio and DWI-ADC ratio can effectively differentiate between ccRCC and fpAML,and the combination of the two can further improve the differential diagnostic efficiency,which is worthy of clinical validation.
万方数据
维普
