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目的明确磁敏感加权成像(SWI)肿瘤内磁敏感信号(ITSS)与灌注加权成像(PWI)转运常数(Ktrans)之间是否存在相关性,以及两者在肾透明细胞癌(ccRCC)分级诊断中的应用价值。方法选取36例经手术病理证实为ccRCC并进行病理Fuhrman核分级(Ⅰ~Ⅳ)评估的患者,行2D多次屏气SWI和肾脏PWI扫描。评估测量ITSS等级与Ktrans的平均值,对FuhrmanⅠ、Ⅱ、Ⅲ3组间分别进行Kruskal-Wallis检验和方差分析,并分析ITSS等级和Ktrans平均值之间的相关性;同时应用受试者工作特征(ROC)曲线分析其分级诊断效能。结果 Fuhrman分级Ⅰ级8例、Ⅱ级16例、Ⅲ级12例,对应的ITSS等级分别为1.25±0.43、1.75±0.83和2.20±0.75,Ktrans值分别为(0.24±0.07)、(0.31±0.08)和(0.34±0.07)min-1,不同Fuhrman分级间ITSS等级和Ktrans值差异均有统计学意义(χ2=6.089,P<0.05;F=4.116,P<0.05)。ITSS与Ktrans总体呈中度正相关(r=0.536,P<0.01)。以ITSS和Ktrans的ROC曲线鉴别高、低级别(FuhrmanⅢvsⅠ~Ⅱ)ccRCC的曲线下面积(AUC)、敏感性和特异性相对较高,分别为0.737、80.0%、37.5%和0.737、90.0%、68.8%。结论 ITSS和Ktrans可以为ccRCC术前分级诊断提供更加丰富的信息,从而有助于手术方案的制定及预后的判断。
OBJECTIVE: To determine whether there is a correlation between magnetic resonance imaging (ITSS) and perfusion-weighted imaging (PWI) transport constants (Ktrans) in magnetically susceptible weighted imaging (SWI) The application value. Methods Thirty - six patients with pathologically confirmed ccRCC and pathological Fuhrman nuclear classification (Ⅰ ~ Ⅳ) were selected and screened by 2D multiple breath - hold SWI and renal PWI. Kruskal-Wallis test and analysis of variance were performed on FuhrmanⅠ, Ⅱ and Ⅲ groups respectively, and the correlation between ITSS grade and Ktrans mean was analyzed. At the same time, the working characteristics of subjects ROC) curve analysis of its classification diagnostic efficacy. Results Fuhrman grade Ⅰ 8 cases, grade Ⅱ 16 cases, grade Ⅲ 12 cases, corresponding ITSS grade were 1.25 ± 0.43,1.75 ± 0.83 and 2.20 ± 0.75, Ktrans values were (0.24 ± 0.07), (0.31 ± 0.08 ) And (0.34 ± 0.07) min-1, respectively. The differences of ITSS grade and Ktrans value between different Fuhrman grades were statistically significant (χ2 = 6.089, P <0.05; F = 4.116, P <0.05). There was a moderate positive correlation between ITSS and Ktrans (r = 0.536, P <0.01). The area under the curve (AUC) of high and low grade (Fuhrman ⅢvsⅠ ~ Ⅱ) ccRCC was identified by ROC curves of ITSS and Ktrans with high sensitivity and specificity of 0.737, 80.0%, 37.5% and 0.737, 90.0% 68.8%. Conclusion ITSS and Ktrans can provide more abundant information for the preoperative classification of ccRCC, which is helpful for the development of surgical plans and the judgment of prognosis.