| 温学炜,周少鹏,康欢欢,黄庆波,丁效蕙,赵建,白旭,王美凤,陈一博,易思成,李朝博,王海屹.对比脂肪抑制与非脂肪抑制T2WI术前预测肾细胞癌致下腔静脉癌栓并侵犯静脉壁[J].中国医学影像技术,2026,42(3):393~398 |
| 对比脂肪抑制与非脂肪抑制T2WI术前预测肾细胞癌致下腔静脉癌栓并侵犯静脉壁 |
| Comparison on fat-suppressed and non-fat-suppressed T2WI for predicting tumor thrombus in inferior vena cava caused by renal cell carcinoma involving venous wall |
| 投稿时间：2026-01-09 修订日期：2026-03-08 |
| DOI：10.13929/j.issn.1003-3289.2026.03.015 |
| 中文关键词: 癌,肾细胞 腔静脉,下 磁共振成像 癌栓 侵犯静脉壁 脂肪抑制 |
| 英文关键词:carcinoma,renal cell vena cava,inferior magnetic resonance imaging tumor thrombus venous wall invasion fat suppression |
| 基金项目:国家自然科学基金(U24A20755)、北京市自然科学基金(L248017)。 |
| 作者 | 单位 | E-mail | | 温学炜 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 周少鹏 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 康欢欢 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 黄庆波 | 中国人民解放军总医院第一医学中心泌尿外科, 北京 100853 | | | 丁效蕙 | 中国人民解放军总医院第一医学中心病理诊断科, 北京 100853 | | | 赵建 | 中国人民解放军总医院第二医学中心放射诊断科, 北京 100853 | | | 白旭 | 中国人民解放军总医院第五医学中心放射诊断科, 北京 100039 | | | 王美凤 | 中国人民解放军总医院第六医学中心放射诊断科, 北京 100048 | | | 陈一博 | 中国人民解放军总医院第一医学中心泌尿外科, 北京 100853 | | | 易思成 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 李朝博 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | | | 王海屹 | 中国人民解放军总医院第一医学中心放射诊断科, 北京 100853 | wanghaiyi301@outlook.com |
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| 中文摘要: |
| 目的 比较脂肪抑制(FS)与非脂肪抑制(NFS)T2WI预测肾细胞癌(RCC)致下腔静脉(IVC)癌栓并侵犯静脉壁的效能。方法 前瞻性纳入50例RCC致IVC癌栓,术前以相同参数采集腹部轴位FS-T2WI和NFS-T2WI。根据术后病理显示IVC壁有无受侵将其分为侵犯组(n=29)与未侵犯组(n=21);对比2种序列预测RCC致IVC癌栓并侵犯IVC壁的敏感度、特异度、准确率、阳性预测值、阴性预测值及其受试者工作特征曲线下面积(AUC),以Kappa检验评估观察者间一致性。结果 组间术前尿素水平、尿白细胞阳性率、T分期、癌栓Mayo分级及301分级差异均有统计学意义(P均＜0.05)。基于FS-T2WI判断的IVC壁连续性中断、癌栓侵及IVC壁及壁接触面不规则组间差异均有统计学意义(P均＜0.001且AUC均＞0.75),而观察者间差异均无统计学意义(P均＞0.05);基于NFS-T2WI判断结果组间差异亦均有统计学意义(P均＜0.05),但AUC均低于FS-T2WI(P均＜0.05)。FS-T2WI预测IVC壁受侵的特异度、阳性预测值及AUC均高于NFS-T2WI(P均＜0.05);2种序列预测IVC壁受侵的敏感度及阴性预测值均较高且差异均无统计学意义(P均＞0.05)。观察者间基于FS-T2WI评估结果的一致性良好或极好(Kappa值0.638~0.834),基于NFS-T2WI则为一般或中等(Kappa值0.322~0.521)。结论 FS-T2WI用于预测RCC致IVC癌栓并侵犯静脉壁的效能优于NFS-T2WI。 |
| 英文摘要: |
| Objective To compare the efficacy of fat-suppressed (FS)-T2WI and non-FS (NFS)-T2WI for predicting tumor thrombus in inferior vena cava (IVC) caused by renal cell carcinoma (RCC) involving venous wall. Methods Totally 50 RCC patients with tumor thrombus in IVC were prospectively enrolled. Preoperative abdominal MR examination was performed, and axial FS-T2WI and NFS-T2WI were obtained with the same parameters. The patients were divided into invasive group (n=29) and non-invasive group (n=21)according to postsurgery pathologic findings. The sensitivity, specificity, accuracy, positive and negative predictive values, and the area under the receiver operating characteristic curve (AUC) of prediction of each sequence were calculated and compared, and inter-observer consistency was evaluated using Kappa test. Results Significant differences of preoperative urea level, urine leukocyte positivity, T staging, Mayo classification of tumor thrombus, as well as of 301 grading were found between 2 groups (all P＜0.05). Significant differences of evaluation results of IVC wall continuity interruption, tumor thrombus infiltration into IVC wall and irregular wall contact surface were noticed between groups based on FS-T2WI (all P＜0.001 and all AUC＞0.75), but not between observers (all P＞0.05). Such differences were also found based on NFS-T2WI (all P＜0.05), but its AUC were lower than FS-T2WI (all P＜0.05). The specificity, positive predictive value and AUC of FS-T2WI for predicting IVC wall invasion were all higher than those of NFS-T2WI (all P＜0.05). The sensitivity and negative predictive value of FS-T2WI and NFS-T2WI for predicting IVC wall invasion were both high, which were not significantly different (both P＞0.05). Good or excellent consistency of inter-observer consistency were noticed based on FS-T2WI (Kappa values: 0.638—0.834), which were average or moderate based on NFS-T2WI (Kappa values: 0.322—0.521). Conclusion The efficacy of FS-T2WI for predicting tumor thrombus in IVC caused by RCC involving venous wall was superior to that of NFS-T2WI. |
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