目的探讨氨基质子转移(APT)MRI对胶质瘤分级、异柠檬酸脱氢酶(IDH)、Ki-67、p53表达水平的诊断及预测价值。资料与方法回顾性分析59例胶质瘤患者的MRI平扫、增强扫描图像、APT图像及其病理和免疫组化资料,在APT图像上观察肿瘤及其周围...目的探讨氨基质子转移(APT)MRI对胶质瘤分级、异柠檬酸脱氢酶(IDH)、Ki-67、p53表达水平的诊断及预测价值。资料与方法回顾性分析59例胶质瘤患者的MRI平扫、增强扫描图像、APT图像及其病理和免疫组化资料,在APT图像上观察肿瘤及其周围信号特点,并将APT图像分为5个等级。分析APT图像等级与肿瘤WHO分级的相关性,判断随APT图像等级增高IDH野生型、Ki-67、p53高表达所占百分比的变化趋势,比较APT图像等级在胶质瘤高低级别、不同IDH状态、不同Ki-67、p53表达水平之间的差异,采用受试者工作特征(ROC)曲线分析诊断效能。结果 59例胶质瘤中,WHOⅡ级22例,Ⅲ级12例,Ⅳ级25例。59例中IDH突变型22例,野生型37例;Ki-67低表达6例,高表达53例;54例中p53低表达14例,高表达40例。APT图像等级与WHO分级呈显著正相关(r=0.6,P<0.001),随APT图像等级增高,IDH野生型与突变型、Ki-67、p53高表达与低表达之间的比率逐渐上升(χ2 for trend=7.251,P=0.007;χ2 for trend=4.229,P=0.04;χ2 for trend=6.387,P=0.011);低级别胶质瘤、IDH突变型组、Ki-67低表达组、p53低表达组APT图像等级低于高级别胶质瘤、IDH野生型组、Ki-67高表达组、p53高表达组(P<0.05),ROC曲线下面积分别为0.78、0.703、0.758、0.712(P<0.01)。结论胶质瘤高低级别、不同IDH状态、不同Ki-67及p53表达水平APT图像信号具有差异,定性地应用APT成像可以对免疫组化因子进行诊断和预测。展开更多
Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH...Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.展开更多
文摘目的探讨氨基质子转移(APT)MRI对胶质瘤分级、异柠檬酸脱氢酶(IDH)、Ki-67、p53表达水平的诊断及预测价值。资料与方法回顾性分析59例胶质瘤患者的MRI平扫、增强扫描图像、APT图像及其病理和免疫组化资料,在APT图像上观察肿瘤及其周围信号特点,并将APT图像分为5个等级。分析APT图像等级与肿瘤WHO分级的相关性,判断随APT图像等级增高IDH野生型、Ki-67、p53高表达所占百分比的变化趋势,比较APT图像等级在胶质瘤高低级别、不同IDH状态、不同Ki-67、p53表达水平之间的差异,采用受试者工作特征(ROC)曲线分析诊断效能。结果 59例胶质瘤中,WHOⅡ级22例,Ⅲ级12例,Ⅳ级25例。59例中IDH突变型22例,野生型37例;Ki-67低表达6例,高表达53例;54例中p53低表达14例,高表达40例。APT图像等级与WHO分级呈显著正相关(r=0.6,P<0.001),随APT图像等级增高,IDH野生型与突变型、Ki-67、p53高表达与低表达之间的比率逐渐上升(χ2 for trend=7.251,P=0.007;χ2 for trend=4.229,P=0.04;χ2 for trend=6.387,P=0.011);低级别胶质瘤、IDH突变型组、Ki-67低表达组、p53低表达组APT图像等级低于高级别胶质瘤、IDH野生型组、Ki-67高表达组、p53高表达组(P<0.05),ROC曲线下面积分别为0.78、0.703、0.758、0.712(P<0.01)。结论胶质瘤高低级别、不同IDH状态、不同Ki-67及p53表达水平APT图像信号具有差异,定性地应用APT成像可以对免疫组化因子进行诊断和预测。
基金Fund supported by the Clinical Research Supporting Fund of Chinese PLA General Hospital(2016FC-TSYS-1039)~~
文摘Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.
