摘要
目的探讨磁共振扩散峰度成像(DKI)在弥漫型胶质瘤分级中的应用价值,以及扩散峰度指标在肿瘤细胞增殖活度无创评价中的价值。方法搜集经手术病理证实的胶质瘤患者54例(WHOⅡ胶质瘤14例,WHOⅢ胶质瘤18例,WHOⅣ胶质瘤22例),行MRI常规序列及DKI序列扫描,计算得到平均扩散峰度(MK)、轴向峰度(Ka)、径向峰度(Kr)、平均扩散系数(MD)、各向异性分数(FA)图。手动勾画肿瘤实质及对侧正常脑白质为感兴趣区,比较不同级别胶质瘤感兴趣区DKI相关参数值的差异性,采用受试者工作特征曲线评估这些参数的诊断效能及各参数值与Ki-67标记指数的相关性。结果各参数在胶质瘤与对侧正常脑白质存在差异(P<0.05)。低级别胶质瘤和高级别胶质瘤MK、Ka、Kr、ADC值差异有统计学意义(P<0.05)。MK值在Ⅱ和Ⅲ级肿瘤之间(P<0.05)、在Ⅲ和Ⅳ级肿瘤之间(P<0.01)有显著差异,并随等级增加而增加。MK具有最大的曲线下面积(AUC=0.846,特异性最高95%),MK值与Ki-67存在正相关关系(r=0.618)。ADC、Ka、Kr值在Ⅲ级和Ⅳ级肿瘤有差异(P<0.05)。FA值在各级别之间均未显示显著差异(P=0.124)。结论DKI中MK参数在高、低级别胶质瘤鉴别中具有较高的特异性和敏感性,可以更好地鉴别高、低级别胶质瘤,DKI技术可以无创性评估胶质瘤微观结构的变化。
Objective to investigate the value of diffusion kurtosis imaging(DKI)in the grading of diffuse glioma and the value of diffusion kurtosis index in the noninvasive evaluation of tumor cell proliferation activity.Methods 54 patients with glioma confirmed by surgery and pathology(14 cases of WHOⅡglioma,18 cases of WHOⅢglioma,22 cases of WHOⅣglioma)were collected,and routine MRI sequence and DKI sequence scanning were performed,and the average spread peak was calculated as well as degree(MK),axial kurtosis(Ka),radial kurtosis(Kr),average diffusion coefficient(MD),anisotropy fraction(FA)graphs.We manually delineated the tumor parenchyma and the contralateral normal white matter as the area of interest,compared the differences in DKI-related parameter values in the area of interest of different grades of glioma,and used receiver operating characteristic curves to evaluate the diagnostic performance of these parameters and the value of each parameter.Correlation of Ki-67 marking index was done.Results The parameters were different between the glioma and the contralateral normal white matter(P<0.05).The difference in MK,Ka,Kr,ADC values between low-grade glioma and high-grade glioma was statistically significant(P<0.05).The MK value was significantly different between gradeⅡand gradeⅢtumors(P<0.05),and between gradeⅢandⅣtumors(P<0.01),and it increased with the grade.MK has the largest area under the curve(AUC=0.846,the highest specificity is 95%),and there is a positive correlation between MK and Ki67(r=0.618).ADC,Ka and Kr values were different between gradeⅢandⅣtumors(P<0.05).The FA value showed no significant difference between each level(P=0.124).Conclusion The MK parameters in DKI have high specificity and sensitivity in the identification of high and low grade gliomas.
作者
谢生辉
高阳
李波
赵鹏飞
王少彧
张华鹏
XIE Shenghui;GAO Yang;LI Bo(Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第10期1905-1909,共5页
Journal of Clinical Radiology
基金
内蒙古自治区科技计划资助项目(N0.2019GG047)
关键词
胶质瘤
扩散峰度成像
增殖活度
Glioma
Diffusion kurtosis imaging
Proliferation activity
作者简介
通讯作者:高阳
