| ObjectiveToinvestigatethecontributionofmono-exponential?ADCstan?,bi-exponential?D,D*,f?and stretched exponential model?DDC,??based multiple b value diffusion weighted imaging in the diagnosis of minimal fat angiomyolipoma?MFAML?,clearcellcarcinoma?ccRCC?andnon-clearcell carcinoma?Non-ccRCC?.Materials and methods46 patients with suspected renal neoplasms underwent multiple b value diffusion weighted imaging examination during January,2016 to June,2016.42 patients met the requirements of this study.All patients were divided into three groups.The first group:MFAML group,a total of 9 patients,of which 6 patients were confirmed by surgical pathology and 3 patients were followed up for at least six months.The second group:ccRCC group,a total of 23 patients,of which 22 patients were confirmed by surgical pathology and 1 patient was confirmed by the punctured pathology.The third group:Non-ccRCC group,a total of 10 patients,of which 6 patients of papillary cell carcinoma,2patients of chromophobe cell carcinoma,2 patients of collecting duct cancer,were confirmed by surgical pathology.All patients were scanned using a GE Signa 3.0T magnetic resonance scanner,an8-channelabdominalcoil,andfastedbeforetheinspection.ConventionalMRI sequence:FSE-T2WI transection and coronary position,FSE-T1WI transection.Multiple b value DWI sequence,We used a single-shot spin-plane echo sequence?SE-EPI?,breath-triggeredgating,andselected11bvaluesfrom01000s/mm2?0,20,40,60,80,100,200,400,600,800,1000s/mm2?.At the highest level of tumors,we selected the substantive parts of the three adjacent layers,and the ADCstan,D,D*,f,DDC and?parameters were measured,the average value were taken as the final result.The data were analyzed statistically by using SPSS 19.0 and GraphPad 6.0 softwares.The differences of the parameters between the different groups were compared by single factor analysis of variance.Correlation between ADCstan and DDC,D and DDC,?and DDC parameters were used Pearson correlation analysis.And the ROC curve was used to evaluate the effectiveness of the three model parameters to identify MFAML and ccRCC,MFAML and Non-ccRCC,ccRCC and Non-ccRCC.Result1,The signal strength of MFAML,ccRCC and Non-ccRCC decreased with the increase of b value?01000s/mm2?in the multiple b value DWI.2,The differences of ADCstan,D,D*,DDC and?value between MFAML,ccRCC and Non-ccRCC were statistically significant?p<0.05?,and D,D*,?between MFAML,ccRCC and Non-ccRCC,the difference were statistically significant?p<0.05?;The difference of ADCstan between MFAML and ccRCC was statistically significant?p<0.05?,as well as between ccRCC and Non-ccRCC?p<0.05?;The difference of DDC between MFAML and Non-ccRCC was statistically significant?p<0.05?,also between ccRCC and Non-ccRCC.3,ADCstan and DDC were positively correlated,the correlation coefficients in MFAML,ccRCC and Non-cc RCC were 0.981?p<0.05?,0.966?p<0.05?,0.964?p<0.05?respectively.D and DDC were positively correlated,the correlation coefficients in MFAML,ccRCC and Non-ccRCC were 0.749?p<0.05?,0.761?p<0.05?,0.742?p<0.05?respectively.However,there was no significant correlation between?and DDC.4,The area under the curve were 0.966,0.952,0.942 and 0.901 in the identification of MFAML and ccRCC by D,?,D*and ADCstan respectively.On this base,the sensitivity of diagnosis were 91.3%,95.7%,88.9%and 78.3%,and the specificity were 88.9%,88.9%,87.0%and 88.9%respectivelyby the threshold value of 0.90×10-3mm2/s,0.54,34.90×10-3 mm2/s and 1.36×10-3 mm2/s.The area under the curve were 0.985,0.975,0.922,0.883in the identification of MFAML and Non-ccRCC by D*,?,D,DDC respectively.On this base,the sensitivity of diagnosis were 88.9%,90.0%,80.0%,88.9%,and the specificity were90.0%,88.9%,88.9%,70.0%respectivelybythethresholdvalueof23.20×10-3mm2/s,0.54,0.90×10-3mm2/s and 1.31×10-3mm2/s.The area under the curve were0.909,0.870,0.857 and 0.841 in the identification of ccRCC and Non-cc RCC by D*,?,DDC and ADCstan respectively.On this base,the sensitivity of diagnosis were78.3%,90.0%,73.9%and 73.9%,and the specificity were 90.0%,78.3%,90.0%and 80.0%respectivelyby the threshold value of 16.75×10-3mm2/s,0.76,1.54×10-3mm2/s and1.39×10-3mm2/s.Conclusion1,Mono-exponential,bi-exponential and stretched exponential model based multiple b value diffusion weighted imaging can provide important quantitative basis for the identification of benign and malignant tumors of the kidney.2,D,?,D*,ADCstan diagnostic efficacy are higher in the diagnosis of MFAML and ccRCC,and?has the highest sensitivity,D,?,ADCstan have the hightest specificity.D*,?,D diagnostic efficacy are higher in the diagnosis of MFAML and Non-ccRcc,and?,ADCstan have the highest sensitivity,D*has the highest specificity.D*diagnostic efficacy is higher in the diagnosis of ccRCC and Non-ccRCC,and?has the highest sensitivity,D*,DDC have the highest specificity.3,The bi-exponential and stretched exponential model are superior to the Mono-exponential model in the diagnosis of renal neoplasms. |
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