Routinely performed multiparametric magnetic resonance imaging helps to differentiate common subtypes of renal tumours.

Autor: Cornelis, F., Tricaud, E., Lasserre, A., Petitpierre, F., Bernhard, J., Bras, Y., Yacoub, M., Bouzgarrou, M., Ravaud, A., Grenier, N.
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Zdroj: European Radiology; May2014, Vol. 24 Issue 5, p1068-1080, 13p, 4 Black and White Photographs, 1 Diagram, 4 Charts, 1 Graph
Abstrakt: Objectives: To retrospectively evaluate the ability of multiparametric magnetic resonance (MR) imaging to differentiate renal tumours. Methods: MR images from 100 consecutive pathologically proven solid renal tumours without macroscopic fat [57 clear cell, 16 papillary and 7 chromophobe renal cell carcinomas (RCCs), 16 oncocytomas and 4 minimal fat angiomyolipomas (AMLs)] between 2009 and 2012 were evaluated. Two radiologists blinded to pathology results independently reviewed double-echo chemical shift, dynamic contrast-enhanced T1- and T2-weighted images and apparent diffusion coefficient (ADC) maps. Signal intensity index (SII), tumour-to-spleen SI ratio (TSR), ADC ratio, wash-in (WiI) and wash-out indices (WoI) between different phases were calculated. Results: There were significant differences between papillary RCCs and other renal tumours for arterial WiI ( P < 0.001), initial WoI ( P = 0.006) and ADC ratio ( P < 0.001); between chromophobe RCCs and oncocytomas for TSR ( P = 0.02), parenchymal WiI ( P = 0.03), late WiI ( P = 0.02), initial WoI ( P = 0.03) and late WoI ( P = 0.04); and between clear cell RCCs and oncocytomas for SII ( P = 0.01) and parenchymal WiI ( P = 0.01). Papillary RCCs were distinguished from other tumours (sensitivity 37.5 %, specificity 100 %) and oncocytomas from chromophobe RCCs (sensitivity 25 %, specificity 100 %) and clear cell RCCs (sensitivity 100 %, specificity 94.2 %). Conclusion: MR imaging provides criteria able to accurately distinguish papillary RCCs from other tumours and oncocytomas from chromophobe and clear cell RCCs. Key Points: • Multiparametric MR parameters accurately distinguish papillary RCCs with high specificity (100 %). • Oncocytomas can be distinguished from chromophobe RCCs with high specificity (100 %). • Oncocytomas can be distinguished from clear cell RCCs with high specificity (94.2 %). • In oncocytomatosis, imaging follow-up with such parameters analysis could be promoted. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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