| Objective:To explore the MRI features of renal cell carcinoma of different pathological subtype, and it can provide help to the diagnosis of the pathological classification before the histological examination. It can provide help to the selection of different surgery and the prognosis after the surgery.Methods:We retrospectively analyze47patients between January2009and June2013which postoperative pathological diagnosis is renal cell cancer. The age of these patients is between31～83years old, and the average age is24.7±10.7. There are23cases with the left side renal cell cancer and24cases with the right side renal cell cancer. All patients are completed the examination of B-made ultrasound, CT and MRI and the postoperative pathological diagnoses are renal clear cell carcinoma or renal papillary cell carcinoma or renal chromophobe cell carcinoma.We analyze the renal cell cancer characteristics of MRI images with visual inspection and making the signal of normal renal cortical as the standard. Finally, we use SPSS13.0to make a Chi-square analysis with P=0.05as the standard.Results:These47cases comprise34cases of renal clear cell carcinoma,6cases of renal papillary cell carcinoma, and7cases of renal chromophobe cell carcinoma.Renal clear cell carcinoma as the rich blood flow to tumors, the amplitude of strengthen is significantly higher than the other two subtypes, corticomedullary phase, nephrographic phase and the discharge phase signal strength are greater than the other two subtypes, with statistical significance (P<0.05), and has obvious "fast in fast out" strengthening characteristics.The plain scan signal strength of papillary renal carcinoma is slightly larger than renal clear cell carcinoma, with statistical significance (P<0.05).The amplitude of strengthen signal of papillary renal carcinoma and renal chromophobe cell carcinoma is similar with no statistical significance (P>0.05).The signal strength of renal clear cell carcinoma and papillary renal carcinoma in opposed-phase images in some cases are lower than in-phase images, and renal chromophobe cell carcinoma is without this characteristic, with statistical significance (P<0.05).Compared the three kinds of tumors, renal clear cell carcinoma has calcification, hemorrhage, cystic region and so on are more than papillary renal carcinoma and renal chromophobe cell carcinoma.All of the three kinds renal cell carcinoma are similar on DWI and ADC image, and they are slightly high signal on DWI image and slightly high signal on ADC image and with no statistical significance (P>0.05).Conclusion:MRI is significant to identify renal clear cell carcinoma, renal papillary cell carcinoma, renal chromophobe cell carcinoma. The certain reference value of the identification of renal cell carcinoma and renal papillary cell carcinoma is the enhancement MRI.The chemical shift imaging is more useful than CT to identify renal papillary cell carcinoma and renal chromophobe cell carcinoma;secondly, and it also can use to identify renal clear cell carcinoma and renal chromophobe cell carcinoma, but it cannot identify renal clear cell carcinoma and renal papillary cell carcinoma. It is significance to preoperative assessment,guide the treatment and analysis prognosis. |
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