The Value Of IVIM-DWI And DKI In The Diagnosis Of Renal Neoplasms

Objectives:To discuss the value of IVIM-DWI in the diagnosis and differential diagnosis of renal mass.Material and Methods:The patients who undwent MRI examination because of renal mass from Jan.2014 to Dec. 2014 and followed by diagnosis which was confirmed by pathology were chosen in this study. A total of 48 patients were included, for which 28 men and 20 female. The age range from 41 to 79, and mean age is 59. There are 37 cases of clear cell carcinoma,5 cases of papillary cell carcinoma and 6 cases of angiomyolipomas. All subjects underwent IVIM(b value was set to 0,25,50,75,100,150,200,300,400,600,800s/mm2) sequence besideds of the abdominal conventional MRI sequence. All examinations were taken in the 3.0 T MR (GE MRI 750, USA)machine.All data were input to the AW 4.6 workstation, then were postprocessed by two radiologists who had more than ten years experience. Three layers were choiced for putting region of interest (ROI), in region of mass, in normal region of the cortex and the medulla of the renal.Slow-ADC, f, and Fast-ADC were calculated by IVIM-DWI. Prameters derived from kinds of masses were compared by analysis of variance, and the prameters derived from the normal renal region of the same patients were compared by t test. Operating characteristic curve analyses were conducted to assess IVIM in the diagnosis and differential diagnosis of the renal mass.Result:The data calculated from IVIM sequences showed that, the value of f (0.46±0.11、 0.26±0.07,p<0.01) and Fast-ADC ((118.67±20.58)×10-3mm2/s. (58.08±15.96)×10-3mm2/s, p <0.01) has statistically difference while the value of Slow-ADC ((1.26±0.15)×10-3mm2/s、 (1.21±0.13)×10-3mm2/s, p>0.05) has no statistically difference between the normal cortex and medulla; the value of Slow-ADC of the angiomyolipoma and of the papillary carcinoma has no statistically difference, while the two have statistically difference with of clear cell carcinoma ((0.53±0.06)×10-3mm2/s、(0.47±0.16)×10-3mm2/s、(1.22±0.11)×10-3mm2/s,p<0.05); the value of Fast-ADC of the angiomyolipoma and of the clear cell carcinoma has no statistically difference, while the two have statistically difference with of the papillary carcinoma ((114.6±20.85)×10-3mm2/s、(108.25±22.54)×10-3mm2/s、(39±22.55)×10-3mm2/s,p<0.05); the value of f of the angiomyolipoma and of the clear cell carcinoma and of the papillary carcinoma has statistically difference in each other(0.43±0.05.0.34±0.04、0.26±0.03, p<0.05).The area under the curve in operating characteristic curve analyses is 0.94 of the diagnosis of the clear cell carcinoma and 0.99 of the diagnosis of the papillary carcinoma within f of IVIM.Conclusion:The parameter f of the IVIM has clinical application value in diagnosis and differential diagnosis of the renal mass.Objectives:To discuss the value of DKI in the diagnosis and differential diagnosis of renal mass.Material and Methods:The patients were the same as part1. All subjects underwent DKI(b value was set to 0,500,1000,1500,2000 s/mm2) sequence besideds of the abdominal conventional MRI sequence. All examinations were taken in the 3.0 T MRI (GE MRI 750, USA) machine.All data were input to the AW 4.6 workstation, then were postprocessed by two radiologists who had more than ten years experience. Three layers were choiced for putting region of interest (ROI), in region of mass, in normal region of the cortex and the medulla of the renal. All parameter values were recorded.MD, MK and RK were calculated by DKI. Prameters derived from kinds of masses were compared by analysis of variance, and the prameters derived from the normal renal region of the same patients were compared by t test. Operating characteristic curve analyses were conducted to assess DKI in the diagnosis and differential diagnosis of the renal mass.Result:The data calculated from DKI sequences showed that, the value of MD ((3.93Q0.48)x 10"3mm2/s、(2.84±0.34)×10-3mm2/s, p<0.01) and MK (0.58±0.07、0.65±0.06, p <0.05) and RK(0.44±0.12、0.63±0.19, p<0.05) has statistically difference between the normal cortex and medulla; the value of MK of the papillary carcinoma and of the angiomyolipoma has no statistically difference, while the two have statistically difference with of clear cell carcinoma (1.42±0.25、1.31±0.09、0.66±0.08, p<0.05); the value of MD ((4.675±0.62)×10-3mm2/s、 (1.38±0.19)×10-3mm2/s、(2.22±0.13)×10-3mm2/s, p<0.01) and RK (0.57±0.1、1.77±0.41、1.17±0.19, p<0.05) of the clear cell carcinoma and of the papillary carcinoma and of the angiomyolipoma has statistically difference in each other.The area under the curve in operating characteristic curve analyses is 1 of the diagnosis of the clear cell carcinoma and 1 of the diagnosis of the papillsry carcinoma within MD of DKI.The area under the curve in operating characteristic curve analyses is 1 of the diagnosis of the clear cell carcinoma and 0.99 of the diagnosis of the papillsry carcinoma within RK of DKI.Conclusion:The parameters MD and RK of the DKI have clinical application value in diagnosis and differential diagnosis of the renal mass.