Study On The Correlation Of Different Fuhrman Pathologic Grades Of T1Clinical Stages Renal Clear Cell Carcinoma And ADC Values Of Diffusion Weighted Imaging At3.0t MR

Objective: Application of diffusion weighted imaging with T1clinical stage of renalclear carcinoma, to investigate the correlation of its ADC values and Fuhrman pathologicgrade, hoping to provide help for clinical treatment options and prognosis.Methods: A retrospective analysis of the magnetic resonance imaging data of60patients with pathologically confirmed as T1clinical stage in our hospital.60patients wereall performed conventional MRI scan, DWI and strengthen inspection. The maximumtumor diameter were measured by two senior radiologists, the DWI (ADC) images wereread meanwhile on Siemens Syngo image analysis workstation, ADC values weremeasured in the solid part of the tumor, All of the renal clear cell carcinoma were dividedinto four (Ⅰ-Ⅳ) grade by two senior pathologist, which Ⅰ-Ⅱ grade were considering oflow-level group, Ⅲ-Ⅳ grade were considering of high-lever group. SPSS17.0softwarewas applied for statistical analysis. The comparison of the ADC values betweenⅠ-Ⅳ Fuhrman grades, a one-way analysis of variance（ANOVA）was used. The differenceof ADC values between two different grading groups was performed with Student’s t-test,and ROC was used to evaluate the diagnostic efficiency of ADC values, the sensitivity andspecificity. The correlation of ADC values and different pathologic grades of renal clearcell carcinoma using Spearman rank correlation analysis; Using Student’s t-test to evaluaterenal clear cell carcinoma which with the same pathologic grade and have different T1clinical stage. The correlation of ADC values and maximum tumor diameters using Pearson rank correlation analysis.P<0.05was considered to indicate statisticallysignificant in all test.Results: The ADC values of Ⅰ-Ⅳ Fuhrman grade of T1clinical stage renal clearcell carcinoma were (0.919±0.027)×10-3mm2/s,(0.851±0.128)×10-3m2/s,(0.705±0.116)×10-3mm2/s,(0.600±0.274)×10-3mm2/s. There are no significancedifference between grade Ⅰ and Ⅱ, grade Ⅲ and Ⅳ (p=0.11; p=0.09). And there weresignificance differences between grade Ⅰ and Ⅲ grade, grade Ⅰ and Ⅳ grade, Ⅱ and Ⅲgrade level, Ⅱ and Ⅳ grade level (p≤0.00).The mean ADC values of low-level group of T1clinical stage CCRCC was（0.872±0.123）×10-3mm2/s, The mean ADC values of low-level group of T1clinicalstage CCRCC was （0.675±0.110）×10-3mm2/s. The mean ADC values of low-levelgroup was significantly greater than the high-level group, and the difference wasstatistically significant (p=0.00). Taking0.713×10-3mm2/s as the threshold value, thesensitivity and specificity of identification the high and low level groups of T1stageCCRCC were92.9%and72.2%. The Fuhrman grading and ADC values of T1clinicalstage CCRCC showed a significant negative correlation, r=-0.64, p=0.00.Since pathological grading of Fuhrman grade Ⅳ, T1a stage CCRCC was only onecase, it was not included in the statistics. The mean ADC values of Ⅰ、Ⅱ、Ⅲ Fuhrmangrade CCRCC had no significant different between T1a and T1b stages(p values were0.49.0.72,0.88). The correlation of ADC values and maximum tumor diameters is notsignificant (r=-0.17, p=0.21).Conclusion: The Fuhrman pathological grading and ADC values of T1stage CCRCCwere significantly negatively correlated with, in other word, the higher pathological gradelevel, the lower ADC values. ADC values can be used to predict the pathological gradingof T1stage CCRCC, Taking0.713×10-3mm2/s as the threshold value, the area under theROC curve is0.886, then the sensitivity and specificity of identification the high and lowlevel groups of T1stage CCRCC were92.9%and72.2%, and this can help to choose thetreatment of the tumor and prognosis. CCRCC which have the same Fuhrman grade and different clinical stage has no significant difference between ADC values. ADC valuescan be used to forecast prognosis of the CCRCC in the same Fuhrman grade and differentclinical stage, and different stages of renal cell carcinoma had no significant impact on theADC values.