Application of susceptibility weighted and perfusion weighted imaging techniques in diagnosis and grading of clear cell renal cell carcinomas
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Department of Radiology,Tongji Hospital,Tongji University,Department of Radiology,Tongji Hospital,Tongji University,Department of Radiology,Tongji Hospital,Tongji University,Department of Radiology, Tongji Hospital, Tongji University,Department of Radiology,Tongji Hospital,Tongji University,Department of Radiology,Tongji Hospital,Tongji University,Department of Pathology,Tongji Hospital,Tongji University,Department of Pathology,Tongji Hospital,Tongji University,Tongji Hospital,Tongji University;China

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    Abstract:

    Objective To investigate whether the degree of intratumoral susceptibility signal intensity (ITSS) of susceptibility weighted imaging (SWI) correlates with the transfer constant (Ktrans) of perfusion weighted imaging (PWI), and to assess their values in diagnosis and grading of clear cell renal cell carcinoma(ccRCC). Methods Thirty-six patients with pathologically confirmed ccRCC and Fuhrman grades (Ⅰ-Ⅳ) underwent both 2D multi-breath-hold SWI and renal PWI examination. The degree of ITSS and the mean value of Ktrans were evaluated. Kruskal-Wallis test and one-way analysis of variance (ANOVA) were applied to compare the differences among the three groups (Fuhrman Ⅰ,Ⅱand Ⅲ). Spearman correlation coefficient was used to determine the correlation between degree of ITSS and mean value of Ktrans. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic accuracy. Results The degrees of ITSS of Fuhrman grade Ⅰ (8 patients), grade Ⅱ(16 patients) and grade Ⅲ(12 patients) were (1.25±0.43), (1.75±0.83) and (2.20±0.75), with the Ktrans values being (0.24±0.07)min-1, (0.31±0.08)min-1 and (0.34±0.07)min-1 , respectively; statistical significances were found for both degrees of ITSS and Ktrans values among the three Fuhrman groups (χ2=6.089, P<0.05; F=4.116, P<0.05). A positive correlation was found between the degree of ITSS and value of Ktrans (r=0.536, P<0.01). ITSS and value of KtransROC curve analysis was used to distinguish Fuhrman Ⅲ vs Ⅰ-Ⅱ ccRCC, the optimal area under curves (AUCs), sensitivity and specificity were 0.737, 80.0%, 37.5% and 0.737, 90.0%, 68.8%, respectively. Conclusion Both the degree of ITSS and mean value of Ktrans can provide more pre-operative information of ccRCC, helping to make surgical plans and to predict the prognosis.

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History
  • Received:April 26,2015
  • Revised:July 11,2015
  • Adopted:January 06,2016
  • Online: February 26,2016
  • Published:
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