【摘要】 目的 探讨基于磁共振弥散加权成像的表观弥散系数（ADC值）的测量能否用于肾脏原发性肿瘤的鉴别。方法 56例肾脏原发性肿瘤病灶进行不同B值下的ADC值测量,同时测量病灶的相对ADC值（病灶与对侧相对正常肾实质的ADC值之比）,24例正常志愿者的双侧肾实质ADC值作为对照。结果 56例肿瘤中包括28例透明细胞癌,1 6例非透明细胞癌,12例血管平滑肌脂肪瘤,平均ADC值分别为（1.767±0.280）×10^-3mm²/s、（1.386±0.327）×10^-3mm²/s、（1.319±0.193）×10^-3mm²/s;相对ADC值分别为（0.89±0.17）×10^-3mm²/s、（0.72±0.16）×10^-3mm²/s、（0.60±0.08）×10^-3mm²/s;正常肾实质ADC值为（2.110±0.088）×10^-3mm²/s。透明细胞癌相对ADC值高于非透明细胞癌及血管平滑脂肪瘤（P<0.05）,正常肾实质ADC值高于各肾脏肿瘤的ADC值（P<0.05）,透明细胞癌ADC值高于血管平滑肌脂肪瘤（P<0.05）,而透明细胞癌与非透明细胞癌,非透明细胞癌与血管平滑肌脂肪瘤间的ADC值差异无统计学意义。结论 肾脏肿瘤的ADC值低于正常肾实质,其中透明细胞癌的ADC值相对较高,而血管平滑肌脂肪瘤相对较低,磁共振弥散加权成像的ADC值测量对肾脏原发性肿瘤鉴别有重要的价值,相对ADC值的测量可能较直接的ADC值测量更有价值更多还原

【Abstract】 Objective The purpose of this study was to explore whether the apparent diffusion coefficient(ADC value) which is based on diffusion weighted imaging can be used to differentiate primary renal tumors.Methods The ADC values of the renal tumors in 56 patients were measured with different b values,and the relative ADC values were calculated by lesions versus normal renal parenchyma.The ADC values of the bilateral renal parenchyma of 24 normal volunteers were measured as control.Results There were 28 clear cell renal cell carcinoms(clear cell RCCs),16 non-clear cell renal cell carcinomas(non-clear cell RCCs) and 12 angiomyolipomas(AMLs) in 56 cases of tumors.The mean ADC values were 1.767 ± 0.280,1.386 ± 0.327,1.319 ±0.193(10-3mm2/S),respectively.The mean relative ADC values were 0.89 ±0.17,0.72±0.16,0.60±0.08,respectively.The ADC value ofnormal renal parenchyma was 2.110 ±0.088(10-3mm~2/S).The relative ADC value of the clear cell RCCs was higher than non-clear cell RCCs and AMLs(P< 0.05),the ADC value of normal renal parenchyma was higher than renal tumors(P<0.05),and the ADC value of clear cell RCCs was higher than AMLs(P< 0.05),but there were no significant differences between clear cell RCCs and nonclear cell RCCs,as well as AMLs and non-clear RCCs.Conclusion ADC values of renal tumors were lower than renal parenchyma,and the ADC value of clear cell RCCs was relatively higher,AMLs was relatively lower.The measurement of ADC value based on diffusion weighted magnetic resonance imaging is useful to differentiate primary renal tumors.更多还原