The role of diffusion-weighted MRI and contrast-enhanced MRI for differentiation between solid renal masses and renal cell carcinoma subtypes

医学 肾细胞癌 磁共振弥散成像 有效扩散系数 肾病科 清除单元格 磁共振成像 放射科 肾透明细胞癌 内科学 核医学 病理
作者
Asli Serter,Mehmet Ruhi Onur,Ganime Çoban,Pelin Yildiz,Abdullah Armagan,Ercan Kocakoc
出处
期刊:Abdominal Imaging [Springer Nature]
卷期号:46 (3): 1041-1052 被引量:6
标识
DOI:10.1007/s00261-020-02742-w
摘要

To assess the value of diffusion-weighted magnetic resonance imaging (DW-MRI) and contrast-enhanced MRI (CE-MRI) for differentiation between benign and malignant solid renal masses, renal cell carcinoma (RCC) subtypes, oncocytomas, and lipid-poor angiomyolipomas (LP-AML). Minimum or lowest ‘apparent diffusion coefficient’ (ADC1) and representative ADC values (ADC2) of 112 renal masses (n: 46 benign renal mass, n: 66 malignant renal mass) were measured on DW-MRI images (b 50, 400, 800 s/mm2). Signal intensity (SI) measurements were performed in normal renal parenchyma and most avid enhanced area of the renal masses at precontrast, corticomedullary, and nephrographic phases on CE-MRI. Contrast enhancement rate (CER) and contrast enhancement index (CEI) values of renal masses were compared between benign-malignant renal masses and RCC subtypes, oncocytomas, and LP-AMLs. There was no significant difference between ADC1, ADC2 values, and SI of benign and malignant renal masses (p = 0.721, p = 0.255, p = 0.872). Mean ADC1 and ADC2 values of clear cell RCCs were significantly higher than nonclear cell RCCs (p = 0.005 p = 0.002). Mean CER value of clear cell RCCs was significantly higher than nonclear cell RCCs in nephrographic phase (p = 0.003). Mean CEI values of clear cell RCCs were significantly higher than nonclear cell RCCs in the corticomedullary and nephrographic phase (p = 0.027 vs. 0.008). LP-AMLs were differentiated from other renal masses with wash-out phenomenon. Combined usage of ADC, SI, CER, and CEI values may be useful for discrimination between RCC subtypes, oncocytomas, and lipid-poor AMLs.
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