Renal angiomyolipoma with minimal fat: Differentiation trom other neoplasms at double-echo chemical shift FLASH MR imaging

被引:130
作者
Kim, JK
Kim, SH
Jang, YJI
Ahn, H
Kim, CS
Park, H
Lee, JW
Kim, S
Cho, KS
机构
[1] Univ Ulsan, Dept Radiol, Asan Med Ctr, Seoul 138736, South Korea
[2] Univ Ulsan, Dept Urol, Asan Med Ctr, Seoul 138736, South Korea
[3] Pusan Natl Univ Hosp, Dept Radiol, Pusan, South Korea
关键词
D O I
10.1148/radiol.2391050102
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To prospectively evaluate the diagnostic performance or double-echo gradient-echo (GRE) chemical shift magnetic resonance (MR) imaging in the differentiation of angiomyolipoma (AML) with minimal fat front other renal neoplasms. with pathologic examination or follow-Lip data serving as the reference standard. Materials and methods: Institutional review board approval and informed consent were obtained-Double-echo GRE chemical shift MR imaging was performed in 55 patients (29 men and 26 women; mean age, 49 years +/- 14 [standard deviation]) with 55 renal tumors, including 37 (67%) pathologically proved tumors (23 renal cell carcinomas, nine AMLs. two oncocytomas, two lymphomas, and one reninoma) and 18 (33%) clinically diagnosed tumors (17 AMLs and one indeterminate malignancy). All tumors showed no intratumoral Fat and had homogeneous enhancement and a prolonged or gradual enhancement pattern on biphasic helical computed tomographic scans. Signal intensity was measured in the renal tumor and spleen on in-phase and opposed-phase images. The signal intensity index and tumor-to-spleen ratio in AMLs and non-AMLs were calculated and compared with the Student t test. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic accuracy of the signal intensity index and tumor-to-spleen ratio and to extract. the optimal cut-off values in the differentiation of AMLs and non-AMLs. Results: The signal intensity index and tumor-to-spleen ratio were different between AMLs (42% +/- 11 and -43% +/- 17, respectively) and non-AMLs (5% +/- 14 and -4% +/- 16, respectively) (P < .001). The area under the ROC curve was 0.975 for the signal intensity index and 0.952 for the tumor-to-spleen ratio. For differentiation of AMLs from non-AMLs, sensitivity and specificity were (a) 96% and 93%, respectively, with a signal intensity index of 25% and (b) 88% and 97%, respectively, with a tumor-to-spleen ratio or -32%. Conclusion: Double-echo GRE chemical shift, NIB imaging can be used to differentiate AML, with minimal fat from other renal neoplasms. (c) RSNA, 2006.
引用
收藏
页码:174 / 180
页数:7
相关论文
共 21 条
[1]   Pancreatic metastasis from clear cell renal carcinoma: Diagnosis with chemical shift MRI. [J].
Carucci, LR ;
Siegelman, ES ;
Feldman, MD .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1999, 23 (06) :934-936
[2]   INTRATUMORAL FAT IN A RENAL ONCOCYTOMA MIMICKING ANGIOMYOLIPOMA [J].
CURRY, NS ;
SCHABEL, SI ;
GARVIN, AJ ;
FISH, G .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1990, 154 (02) :307-308
[3]   Fat suppression in MR imaging: Techniques and pitfalls [J].
Delfaut, EM ;
Beltran, J ;
Johnson, G ;
Rousseau, J ;
Marchandise, X ;
Cotten, A .
RADIOGRAPHICS, 1999, 19 (02) :373-382
[4]   Chemical shift MR imaging of hyperattenuating (&gt;10 HU) adrenal masses:: Does it still have a role? [J].
Haider, MA ;
Ghai, S ;
Jhaveri, K ;
Lockwood, G .
RADIOLOGY, 2004, 231 (03) :711-716
[5]   Unusual fat-containing tumors of the kidney: A diagnostic dilemma [J].
Helenon, O ;
Merran, S ;
Paraf, F ;
Melki, P ;
Correas, JM ;
Chretien, Y ;
Moreau, JF .
RADIOGRAPHICS, 1997, 17 (01) :129-144
[6]   Chemical shift: The artifact and clinical tool revisited [J].
Hood, MN ;
Ho, VB ;
Smirniotopoulos, JG ;
Szumowski, J .
RADIOGRAPHICS, 1999, 19 (02) :357-371
[7]   Angiomyolipoma: Imaging findings in lesions with minimal fat [J].
Jinzaki, M ;
Tanimoto, A ;
Narimatsu, Y ;
Ohkuma, K ;
Kurata, T ;
Shinmoto, H ;
Hiramatsu, K ;
Mukai, M ;
Murai, M .
RADIOLOGY, 1997, 205 (02) :497-502
[8]   Efficacy of intense screening and treatment for synchronous second primary cancers in patients with esophageal cancer [J].
Kagei, K ;
Hosokawa, M ;
Shirato, H ;
Kusumi, T ;
Shimizu, Y ;
Watanabe, A ;
Ueda, M .
JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2002, 32 (04) :120-127
[9]   Angiomyolipoma with minimal fat: Differentiation from renal cell carcinoma at biphasic helical CT [J].
Kim, JK ;
Park, SY ;
Shon, JH ;
Cho, KS .
RADIOLOGY, 2004, 230 (03) :677-684
[10]   CHARACTERIZATION OF ADRENAL MASSES (LESS-THAN-5 CM) BY USE OF CHEMICAL-SHIFT MR-IMAGING - OBSERVER PERFORMANCE VERSUS QUANTITATIVE MEASURES [J].
MAYOSMITH, WW ;
LEE, MJ ;
MCNICHOLAS, MMJ ;
HAHN, PF ;
BOLAND, GW ;
SAINI, S .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1995, 165 (01) :91-95