医学
盒内非相干运动
肾细胞癌
接收机工作特性
有效扩散系数
血栓
核医学
磁共振弥散成像
曼惠特尼U检验
放射科
肾切除术
一致性(知识库)
磁共振成像
外科
内科学
肾
数学
几何学
作者
Jian Zhao,Meifeng Wang,Xiaohui Ding,Yonggui Fu,Cheng Peng,Huanhuan Kang,Huiping Guo,Xu Bai,Qingbo Huang,Shi‐Ping Zhou,Xiaojing Zhang,Kan Liu,Lin Li,Huiyi Ye,Xu Zhang,Xin Ma,Haiyi Wang
摘要
Venous tumor thrombus (VTT) consistency of renal cell carcinoma (RCC) is an important consideration in nephrectomy plus thrombectomy. However, evaluation of VTT consistency through preoperative MR imaging is lacking.To evaluate VTT consistency of RCC through intravoxel incoherent motion-diffusion weighted imaging (IVIM-DWI) derived parameters (Dt , Dp , f, and ADC) and the apparent diffusion coefficient (ADC) value.Retrospective.One hundred and nineteen patients (aged 55.8 ± 11.5 years, 85 male) with histologically-proven RCC and VTT who underwent radical resection.3.0-T; two-dimensional single-shot diffusion-weighted echo planar imaging sequence at 9 b-values (0-800 s/mm2 ).IVIM parameters and ADC values of the primary tumor and the VTT were calculated. The VTT consistency (friable vs. solid) was determined through intraoperative findings of two urologists. The accuracy of VTT consistency classification based on the individual IVIM parameters of primary tumors and of VTT, and based on models combining parameters, was assessed. Type of operation, intra-operative blood loss, and operation length were recorded.Shapiro-Wilk test; Mann-Whitney U test; Student's t-test; Chi-square test; Receiver operating characteristic (ROC) analysis. Statistical significance level was P < 0.05.Of the enrolled 119 patients, 33 patients (27.7%) had friable VTT. Patients with friable VTT were significantly more likely to experience open surgery, have significantly more intraoperative blood loss, and significantly longer operative duration. The area under the ROC curve (AUC) values of Dt of the primary tumor and VTT in classifying VTT consistency were 0.758 (95% CI 0.671-0.832) and 0.712 (95% CI 0.622-0.792), respectively. The AUC value of the model combining Dp and Dt of VTT was 0.800 (95% CI 0.717-0.868). Furthermore, the AUC of the model combining Dp and Dt of VTT and Dt of the primary tumor was 0.886 (95% CI 0.814-0.937).IVIM-derived parameters had the potential to predict VTT consistency of RCC.3 Technical Efficacy: Stage 2.
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