期刊
EUROPEAN RADIOLOGY
卷 27, 期 12, 页码 4913-4922出版社
SPRINGER
DOI: 10.1007/s00330-017-4906-9
关键词
Renal cell carcinoma; Renal oncocytoma; Magnetic resonance imaging; Apparent diffusion coefficient; Diffusion-weighted imaging
To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs). We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated. Mean ADC values for renal oncoctytomas were significantly higher than those for chromophobe RCCs (1.59 +/- 0.21 vs. 1.09 +/- 0.29x 10(-3) mm(2)/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930). Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours. aEuro cent ADC values can assist in differentiating renal oncocytomas from chromophobe RCCs. aEuro cent DW imaging possesses better specificity than does contrast-enhanced MR imaging. aEuro cent Combining the two parameters provides higher specificity regarding the differential diagnosis.
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