| Objective:signal attenuation is obtained by using multiple b-values as IVIM of MR diffusion weighted imaging for determining the histological element, tiny blood supply and nucleus degrees of clear cell renal cell carcinoma.Materials and Methods:Usefulness of conventional sequence and IVIM at Skyro3. OTesla Siemens, with abdomen body coil and Respiratory Gating System triggering. Each person will take the exam of MRI with frequent sequence of T1WI、T2WI、T2-FSE、 IVIM. The parameters of the frequent sequences:T1WI-vibe (TR3.58ms, TE1.34ms),T2WI(FSE)(TR4340ms, TE89ms), FOV290X380mm slice thicknes6.0mm. b values of IVIM were chosen for0,50,100,150,200,400and600s/mm2, the parameters of the imaging:TE95ms, TR1600ms, FOV320×320, slice thickness2.5mm, divided into5times to finish the scanning. A total of45people were collected,20renal carcinoma patients (male15and female5)who were confirmed as all cell clear renal cell carcinoma by pathology after operation(6are grade1-2,19are grade3-4), aged between30and68years old.They were selected for experimental group.25normal people(male18and female7) who were aged between30and70years old were selected for control group (grade1-2as the first experimental group, grade3-4as the second experimental group). After the examination, the gained imagings were handled by IVIM postprocessing software. Then calculated the perfusion fraction f, the diffusion coefficient D,diffusion coefficient from the perfused compartment D*and apparent diffusion coefficient ADC of renal cortex and medulla in all research objects by IVIM model, we compared these values between healthy renal tissue and the tumor ones, as well as the relevant of parameters between tumor tissue and their nucleus degrees. The region of interests(ROI) were signed three points on every solid parts of the largest section. The last results of ROI were taken the average value of the three. A receiver operating characteristic (ROC) analysis was performed soon afterwards. The study was approved by the institute committee and all patients and volunteers were signed informed consent themselves.Results:1. Healthy renal parenchyma showed higher D values (D=2.13±0.11m2/ms)(P<0.01) than clear cell renal cell carcinoma. The f values for clear cell renal carcinoma were higher than for the normal kidney(grade1-2of f24.4±1.43%, grade3-4of f24.8±1.58%)(p<0.01)2. In the nucleus degrees of clear cell renal carcinoma, the values of D、 D*、D*Xf in the lower degrees as1-2were higher than the higher ones as3-4, it was statistically significant differences and near the pathological results. But the f values had no differences between the grades.Conclusion:1. IVIM imaging can show a feasible way to provide credible diffusion values, detect the degree of cell renal cell carcinoma and improve the accuracy of diagnosis. The D and f values were the best parameters to distinguish clear cell renal carcinoma from healthy renal tissue.2. The values of D、D*、D*Xf can offer a mensurable according to the nucleus degrees of clear cell renal carcinoma, it can distinguish grade malignancy of clear cell renal carcinoma on a pathological level. We will do better on the research of clinic and radiology in every tumor of all organs, as well as the grade of the tumor from every organs. |
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