synopsis

To investigate if the mean diffusivity (MD) and mean kurtosis (MK) allows assessment of renal clinical pathology. MK were better than MD values in identifying the grade of nuclear grade. A significant difference between high and low grade in MVD, MVA, and ki-67 was found.l DKI may predict angiogenesis and proliferative activity in CCRCC and make a plan for preoperative assessment.

introduction

To investigate if the mean diffusivity (MD) and mean kurtosis (MK) allows assessment of renal clinical pathology, including microvessel density (MVD), microvessel area (MVA), and ki-67.

methods

Thirty-three patients were enrolled in this study, with a clear cell renal cell carcinoma (CCRCC) confirmed by surgical pathology. For diffusion kurtosis imaging, a coronal echo planar imaging (EPI) sequence was performed (repetition time: 4000 ms; echo time: 99 ms; diffusion direction: 3; number of acquisitions: 4; b=0, 800, and 1600 s/mm2; and slice thickness: 4 mm with no intersection gap). MD, MK, MVD, MVA, and ki-67 were compared between the different nuclear grades. Correlations between MVD, MVA, and ki-67 and DKI parameters were evaluated.

results

The MDs of low grade and high grade CCRCCs were 2.43±0.11×10-3 mm2/s and 2.22±0.07×10-3 mm2/s, respectively. The MK was 0.73±0.03 and 0.82±0.04, respectively. MK were better than MD values in identifying the grade of nuclear grade. A significant difference between high and low grade in MVD, MVA, and ki-67 was found (t=-8.23, -15.47, and -7.84, respectively, P<0.05). Significant negative correlations between the MD value and MVD, MVA, and ki-67 were observed (r=-0.710, -0.746, and -0.733, respectively, P<0.05). Significant positive correlations between the MK value and MVD, MVA, and ki-67 were observed (r=0.787, 0.772, and 0.801, respectively, P<0.05).

conclusion and discussion

DKI identified renal pathologies associated with CCRCC by MD and MK values. MD correlated negatively with the degree of MVD, and ki-67, and MK showed opposite correlations. The larger volume, less extracellular space limits the movement of water molecules for high nuclear grade, and MK values are thought to be indices of tissue microstructural complexity and heterogeneity.The poor vascularization led to the relatively slow blood flow rate in the tumor blood vessels, less tumor stroma, and a lack of normal tubular structures that reduced the dispersion in the interstitial mass. Thus, DKI may be valuable for noninvasive preoperative surgical planning, therapeutic efficacy evaluations and evaluation of prognosis.

Acknowledgements

No

References

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