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• Clinical Article •
Susceptibility weighted imaging in differentiating papillary from chromophobe renal cell carcinoma
ZHANG Yong-cheng  YU Sheng-nan  CHEN Jie  SUN Jun  XING Shi-jun  CHEN Tong-bing 

DOI:10.12015/issn.1674-8034.2016.12.006.


[Abstract] Objective: To differentiate papillary RCC (pRCC) from chromophobe RCC (CRCC) based on intratumoral susceptibility signals (ITSSs) detected on SWI.Materials and Methods: A retrospective review was performed on patients with CRCC (n=9) or pRCC (n=12) classified by pathology. The ITSSs were classified into hemorrhage and microvessels based on their morphology. Nonparametric Mann-Whitney test was used to compare the differences in the dominant structure of ITSSs, the number of intratumoral vessels and hemorrhagic lesions, and the ratio of ITSS area on SWI between pRCC and CRCC. The diagnostic values of the dominant structure of ITSSs, the number of intratumoral vessels and hemorrhagic lesions, and the ratio of ITSS area on SWI in differentiating pRCCs from CRCCs were compared by receiver operating characteristics (ROC).Results: ITSSs were seen in 18 of 21 patients. No ITSSs were seen in 3 patients with CRCC. Mean scores of dominant structures of ITSSs on SWI were significantly higher for pRCCs than that for CRCCs (P<0.005). There was significant difference of the ratio of ITSS area on SWI between pRCCs and CRCCs (P<0.05). The number of hemorrhagic lesions in pRCCs was significantly larger than that in CRCCs (P<0.05). The occurrence of intratumoral hemorrhage was more common in pRCCs (12/12, 100%) than that in CRCCs (6/9, 66.67%). The number of intratumoral hemorrhagic lesions revealed the highest positive predictive value (100%) and specificity (100%) as compared with other features, while the ratio of ITSS area on SWI showed the highest positive predictive value (87.5%) and sensitivity (88.89%).Conclusion: SWI is a useful technique to analyze the structural difference between pRCC and CRCC by the dominant structures ITSSs, the number of intratumoral hemorrhagic lesions, as well as the ratio of ITSS area on SWI.
[Keywords] Magnetic resonance imaging；Susceptibility weighted imaging；Kidney neoplasms；Carcinoma, renal cell；Subtype

ZHANG Yong-cheng Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

YU Sheng-nan* Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

CHEN Jie Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

SUN Jun Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

XING Shi-jun Department of Radiology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

CHEN Tong-bing Department of Pathology, Affiliated Third Hospital of Suzhou University, Changzhou 213000, China

*Correspondence to: Yu SN, E-mail: 15851921163@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of National Natural Science Foundation of China No. 81371513
Received  2016-09-28
Accepted  2016-11-08
DOI: 10.12015/issn.1674-8034.2016.12.006
DOI:10.12015/issn.1674-8034.2016.12.006.

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