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EADC Values in Diagnosis of Renal Lesions by 3.0 T Diffusion-Weighted Magnetic Resonance Imaging: Compared with the ADC Values.

Zhang YL, Yu BL, Ren J, Qu K, Wang K, Qiang YQ, Li CX, Sun XW - Appl Magn Reson (2012)

Bottom Line: We found renal cell carcinoma (RCC) can be distinguished from angiomyolipoma, and clear cell carcinoma can be distinguished from non-clear cell carcinoma by EADC value.In conclusion, EADC map shows the internal structure of the kidney tumor more intuitively than the ADC map dose, and is also in line with the observation habits of the clinicians.EADC can be used as an effective imaging method for tumor diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging, First Affiliated Hospital, Medicine School of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi People's Republic of China.

ABSTRACT
Exponential apparent diffusion coefficient (EADC) is an indicator of diffusion-weighted imaging (DWI) and reflects the pathological changes of tissues quantitatively. However, no study has been investigated in the space-occupying kidney disease using EADC values. This study aims to evaluate the diagnostic role of EADC values at a high magnetic field strength (3.0 T) in kidney neoplastic lesions, compared with that of the ADC values. Ninety patients with suspected renal tumors (including 101 suspected renal lesions) and 20 healthy volunteers were performed MRI scanning. Diffusion-weighted imaging was performed with a single-shot spin-echo echo-planar imaging (SE-EPI) sequence at a diffusion gradient of b = 500 s/mm(2). We found renal cell carcinoma (RCC) can be distinguished from angiomyolipoma, and clear cell carcinoma can be distinguished from non-clear cell carcinoma by EADC value. There was significant difference in overall EADC values between renal cell carcinoma (0.150 ± 0.059) and angiomyolipoma (0.270 ± 0.108) when b value was 500 s/mm(2). When receiver operating characteristic (ROC) was higher than 0.192, the sensitivity and specificity of EADC value of renal cell carcinoma were 84.6 and 81.1 %, respectively. In conclusion, EADC map shows the internal structure of the kidney tumor more intuitively than the ADC map dose, and is also in line with the observation habits of the clinicians. EADC can be used as an effective imaging method for tumor diagnosis.

No MeSH data available.


Related in: MedlinePlus

Right renal clear cell carcinoma, grade II with in a patient of 63 years old (male). a Enhanced scan in medulla phase, the substantial part of the right kidney lesions showed irregular peripheral enhancement, and the central part with necrosis and cystic degeneration showed no enhancement. b DWI lesions showed mixed high signal intensity in both the tumor parenchyma and central cystic area. c The EADC lesions showed peripheral high signal and central low signal, which was in accordance with what was displayed by enhanced scanning. In the background of gray kidneys, the lesion was highlighted with a clear internal structure. The high signal indicates the substantial part of the tumor. d ADC lesions showed mixed high signal, with high signal in central necrosis part and low signal in surrounding parenchyma part. Compared with the enhanced scan and EADC map, the peripheral part of the kidney was less legible by ADC map. The abdominal intestinal signal was cluttered. Compared with the ADC map, EADC map showed much clean background and much clear image
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Fig2: Right renal clear cell carcinoma, grade II with in a patient of 63 years old (male). a Enhanced scan in medulla phase, the substantial part of the right kidney lesions showed irregular peripheral enhancement, and the central part with necrosis and cystic degeneration showed no enhancement. b DWI lesions showed mixed high signal intensity in both the tumor parenchyma and central cystic area. c The EADC lesions showed peripheral high signal and central low signal, which was in accordance with what was displayed by enhanced scanning. In the background of gray kidneys, the lesion was highlighted with a clear internal structure. The high signal indicates the substantial part of the tumor. d ADC lesions showed mixed high signal, with high signal in central necrosis part and low signal in surrounding parenchyma part. Compared with the enhanced scan and EADC map, the peripheral part of the kidney was less legible by ADC map. The abdominal intestinal signal was cluttered. Compared with the ADC map, EADC map showed much clean background and much clear image

Mentions: The EADC map had a distinct advantage over ADC map. Among 45 lesions of renal cell carcinoma from 44 patients, 12 lesions showed significantly higher DWI performance, higher EADC signal intensity and lower ADC signal intensity. In 33 lesions with mixed high signal in DWI performance, the EADC showed mixed high signal in the background of gray and white kidney, which highlighted the lesions and exhibited a clear structure within lesions. The higher the signal of the area, the higher the EADC value was. The high signal parenchyma within tumor displayed by EADC was in accordance with displayed by enhanced scanning. ADC map showed mixed low signal, and compared with EADC map, ADC map showed relative cluttered background and less clear internal structure within tumor lesions (Fig. 2). Among 33 lesions of renal hamartoma tumor among 23 patients, 26 lesions showed significantly uneven low signal in DWI performance, uneven high signal in EADC performance and low signal shadow in ADC performance. Other seven lesions showed uneven high signal in DWI performance, high signal in EADC performance and low signal in ADC performance (Fig. 3). Renal cysts showed uniform high signal intensity in DWI performance, uniform low signal in EADC performance and high signal in ADC performance. In two cases of Bosniak cyst type II of this study, DWI showed slightly higher signal intensity, and EADC showed low signal with the visible separation. The significantly higher signal displayed by DWI had concealed part of lesion within the structure (Fig. 4).Fig. 2


EADC Values in Diagnosis of Renal Lesions by 3.0 T Diffusion-Weighted Magnetic Resonance Imaging: Compared with the ADC Values.

Zhang YL, Yu BL, Ren J, Qu K, Wang K, Qiang YQ, Li CX, Sun XW - Appl Magn Reson (2012)

Right renal clear cell carcinoma, grade II with in a patient of 63 years old (male). a Enhanced scan in medulla phase, the substantial part of the right kidney lesions showed irregular peripheral enhancement, and the central part with necrosis and cystic degeneration showed no enhancement. b DWI lesions showed mixed high signal intensity in both the tumor parenchyma and central cystic area. c The EADC lesions showed peripheral high signal and central low signal, which was in accordance with what was displayed by enhanced scanning. In the background of gray kidneys, the lesion was highlighted with a clear internal structure. The high signal indicates the substantial part of the tumor. d ADC lesions showed mixed high signal, with high signal in central necrosis part and low signal in surrounding parenchyma part. Compared with the enhanced scan and EADC map, the peripheral part of the kidney was less legible by ADC map. The abdominal intestinal signal was cluttered. Compared with the ADC map, EADC map showed much clean background and much clear image
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3585986&req=5

Fig2: Right renal clear cell carcinoma, grade II with in a patient of 63 years old (male). a Enhanced scan in medulla phase, the substantial part of the right kidney lesions showed irregular peripheral enhancement, and the central part with necrosis and cystic degeneration showed no enhancement. b DWI lesions showed mixed high signal intensity in both the tumor parenchyma and central cystic area. c The EADC lesions showed peripheral high signal and central low signal, which was in accordance with what was displayed by enhanced scanning. In the background of gray kidneys, the lesion was highlighted with a clear internal structure. The high signal indicates the substantial part of the tumor. d ADC lesions showed mixed high signal, with high signal in central necrosis part and low signal in surrounding parenchyma part. Compared with the enhanced scan and EADC map, the peripheral part of the kidney was less legible by ADC map. The abdominal intestinal signal was cluttered. Compared with the ADC map, EADC map showed much clean background and much clear image
Mentions: The EADC map had a distinct advantage over ADC map. Among 45 lesions of renal cell carcinoma from 44 patients, 12 lesions showed significantly higher DWI performance, higher EADC signal intensity and lower ADC signal intensity. In 33 lesions with mixed high signal in DWI performance, the EADC showed mixed high signal in the background of gray and white kidney, which highlighted the lesions and exhibited a clear structure within lesions. The higher the signal of the area, the higher the EADC value was. The high signal parenchyma within tumor displayed by EADC was in accordance with displayed by enhanced scanning. ADC map showed mixed low signal, and compared with EADC map, ADC map showed relative cluttered background and less clear internal structure within tumor lesions (Fig. 2). Among 33 lesions of renal hamartoma tumor among 23 patients, 26 lesions showed significantly uneven low signal in DWI performance, uneven high signal in EADC performance and low signal shadow in ADC performance. Other seven lesions showed uneven high signal in DWI performance, high signal in EADC performance and low signal in ADC performance (Fig. 3). Renal cysts showed uniform high signal intensity in DWI performance, uniform low signal in EADC performance and high signal in ADC performance. In two cases of Bosniak cyst type II of this study, DWI showed slightly higher signal intensity, and EADC showed low signal with the visible separation. The significantly higher signal displayed by DWI had concealed part of lesion within the structure (Fig. 4).Fig. 2

Bottom Line: We found renal cell carcinoma (RCC) can be distinguished from angiomyolipoma, and clear cell carcinoma can be distinguished from non-clear cell carcinoma by EADC value.In conclusion, EADC map shows the internal structure of the kidney tumor more intuitively than the ADC map dose, and is also in line with the observation habits of the clinicians.EADC can be used as an effective imaging method for tumor diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging, First Affiliated Hospital, Medicine School of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi People's Republic of China.

ABSTRACT
Exponential apparent diffusion coefficient (EADC) is an indicator of diffusion-weighted imaging (DWI) and reflects the pathological changes of tissues quantitatively. However, no study has been investigated in the space-occupying kidney disease using EADC values. This study aims to evaluate the diagnostic role of EADC values at a high magnetic field strength (3.0 T) in kidney neoplastic lesions, compared with that of the ADC values. Ninety patients with suspected renal tumors (including 101 suspected renal lesions) and 20 healthy volunteers were performed MRI scanning. Diffusion-weighted imaging was performed with a single-shot spin-echo echo-planar imaging (SE-EPI) sequence at a diffusion gradient of b = 500 s/mm(2). We found renal cell carcinoma (RCC) can be distinguished from angiomyolipoma, and clear cell carcinoma can be distinguished from non-clear cell carcinoma by EADC value. There was significant difference in overall EADC values between renal cell carcinoma (0.150 ± 0.059) and angiomyolipoma (0.270 ± 0.108) when b value was 500 s/mm(2). When receiver operating characteristic (ROC) was higher than 0.192, the sensitivity and specificity of EADC value of renal cell carcinoma were 84.6 and 81.1 %, respectively. In conclusion, EADC map shows the internal structure of the kidney tumor more intuitively than the ADC map dose, and is also in line with the observation habits of the clinicians. EADC can be used as an effective imaging method for tumor diagnosis.

No MeSH data available.


Related in: MedlinePlus