磁敏感加权成像及体素内不相干运动成像在脑胶质瘤术前分级中的应用研究
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摘要
目的:评价磁敏感加权成像(susceptibility weighted imaging,SWI)及体素内不相干运动(intravoxel incoherentmotion,IVIM)成像在脑胶质瘤术前分级中的诊断价值。方法:纳入104例脑胶质瘤患者(低级别33例,高级别71例),术前进行SWI及IVIM成像,术后经病理学检查证实。记录肿瘤内磁敏感信号强度(intratumoral susceptibility signalintensity,ITSS)、快速表观扩散系数(fastapparentdiffusioncoefficient,fast ADC)、慢速表观扩散系数(slow apparent diffusion coefficient,slow ADC)、灌注分数f值及单指数模型参数标准表观扩散系数(standard apparent diffusion coe?cient,standard ADC),用统计学方法对各参数进行分析。结果:高级别脑胶质瘤组的fast ADC、slow ADC、standard ADC和f值分别为(31.2±12.1)×10~(-3)、(0.46±0.22)×10~(-3)、(0.92±0.22)×10~(-3)mm~2/s和0.48±0.13,而低级别脑胶质瘤组的fast ADC、slow ADC、standard ADC和f值分别为(14.0±6.9)×10~(-3)、(0.88±0.24)×10~(-3)、(1.08±0.25)×10~(-3) mm~2/s和0.29±0.13。高级别胶质瘤组的ITSS、fastADC及f值均高于低级别胶质瘤组,差异均有统计学意义(P<0.05)。高级别胶质瘤组的slow ADC及standard ADC值均低于低级别胶质瘤组,差异均有统计学意义(P<0.05)。结论:通过对SWI及IVIM成像进行对比及联合分析,可进一步提高术前脑胶质瘤分级的灵敏度和特异度。
Objective: To evaluate the diagnostic value of susceptibility weighted imaging(SWI) and intravoxel incoherent motion(IVIM) in grading of brain glioma. Methods: Including 104 patients with glioma(33 patients with low-grade glioma, 71 patients with high-grade glioma), SWI and IVIM were performed before operation. All cases were confirmed by postoperative histopathology. Recorded the intratumoral susceptibility signal intensity(ITSS), fast apparent diffusion coefficient(fast ADC),slow apparent diffusion coe?cient(slow ADC), f value and standard apparent diffusion coe?cient(standard ADC). Analysed all parameters with statistical methods. Results: The fast ADC, slow ADC, standard ADC and f value of the high-grade glioma group were(31.2±12.1)×10~(-3),(0.46±0.22)×10~(-3),(0.92±0.22) ×10~(-3) mm~2/s, and 0.48±0.13. The fast ADC, slow ADC, standard ADC,and f value of the low-grade glioma group were(14.0±6.9)×10~(-3),(0.88±0.24)×10~(-3),(1.08±0.25)×10~(-3) mm~2/s, and 0.29±0.13.ITSS, fast ADC and f value of high-grade glioma group were higher than those of low-grade glioma group, the differences were statistically signi?cant(P<0.05). Slow ADC and standard ADC of high-grade glioma group were lower than those of low-grade glioma group, the differences were statistically signi?cant(P<0.05). Conclusion: By comparing and combining SWI and IVIM,the sensitivity and speci?city of preoperative glioma grading were further improved.
Objective: To evaluate the diagnostic value of susceptibility weighted imaging(SWI) and intravoxel incoherent motion(IVIM) in grading of brain glioma. Methods: Including 104 patients with glioma(33 patients with low-grade glioma, 71 patients with high-grade glioma), SWI and IVIM were performed before operation. All cases were confirmed by postoperative histopathology. Recorded the intratumoral susceptibility signal intensity(ITSS), fast apparent diffusion coefficient(fast ADC),slow apparent diffusion coe?cient(slow ADC), f value and standard apparent diffusion coe?cient(standard ADC). Analysed all parameters with statistical methods. Results: The fast ADC, slow ADC, standard ADC and f value of the high-grade glioma group were(31.2±12.1)×10~(-3),(0.46±0.22)×10~(-3),(0.92±0.22) ×10~(-3) mm~2/s, and 0.48±0.13. The fast ADC, slow ADC, standard ADC,and f value of the low-grade glioma group were(14.0±6.9)×10~(-3),(0.88±0.24)×10~(-3),(1.08±0.25)×10~(-3) mm~2/s, and 0.29±0.13.ITSS, fast ADC and f value of high-grade glioma group were higher than those of low-grade glioma group, the differences were statistically signi?cant(P<0.05). Slow ADC and standard ADC of high-grade glioma group were lower than those of low-grade glioma group, the differences were statistically signi?cant(P<0.05). Conclusion: By comparing and combining SWI and IVIM,the sensitivity and speci?city of preoperative glioma grading were further improved.
引文
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[15]BISDAS S, KOH T S, RODER C, et al. Intravoxel incoherent motion diffusion-weighted MR imaging of gliomas:feasibility of the method and initial results[J]. Neuroradiology, 2013,55(10):1189-1196.
[16]BAI Y, LIN Y, TIAN J, et al. Grading of gliomas by using monoexponential, biexponential, and stretched exponential diffusion-weighted MR imaging and diffusion kurtosis MR imaging[J]. Radiology, 2016, 278(2):496-504.
[17]TOGAOO,HIWATASHIA,YAMASHITAK,etal.Differentiation of high-grade and low-grade diffuse gliomas by intravoxel incoherent motion MR imaging[J]. Neuro Oncol,2016, 18(1):132-141.
[2]PARK M J, KIM H S, JAHNG G H. Semiquantitative assessment of intratumoral susceptibility signals using non-contrastenhanced high-field high-resolution susceptibility-weighted imaging in patients with gliomas:comparison with MR perfusion imaging[J]. AJNR Am J Neuroradiol, 2009, 30(7):1402-1408.
[3]LE BIHAN D, BRETON E, LALLEMAND D, et al. MR imaging of intravoxel incoherent motions:application to diffusion and perfusion in neurologic disorders[J]. Radiology, 1986,161(2):401-407.
[4] LIMA M, LE BIHAN D. Clinical intravoxel incoherent motion and diffusion MR imaging:past, present, and future[J].Radiology, 2016, 278(1):13-32.
[5]PUIGJ,SáNCHEZ-GONZáLEZJ,BLASCOG,etal.Intravoxel incoherent motion metrics as potential biomarkers for survival in glioblastoma[J]. PloS One, 2016, 11(7):e0158887.
[6]KIM Y, KO K, KIM D, et al. Intravoxel incoherent motion diffusion-weighted MR imaging of breast cancer:association with histopathological features and subtypes[J]. Br J Radiol,2016, 89(1063):20160140.
[7]KLAUSS M, MAYER P, MAIER-HEIN K, et al. IVIMdiffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions-evaluation with two different MR scanners[J]. Eur J Radiol, 2016, 85(7):1289-1294.
[8]MARCHANDAJ,HITTIE,MONGEF,etal.MRI quantification of diffusion and perfusion in bone marrow by intravoxel incoherent motion (IVIM) and non-negative least square (NNLS) analysis[J]. Magn Reson Imaging, 2014,32(9):1091-1096.
[9]GUO T, CHEN J, WU B, et al. Use of intravoxel incoherent motion diffusion-weighted imaging in identifying the vascular and avascular zones of human meniscus[J]. J Magn Reson Imaging, 2017, 45(4):1090-1096.
[10]HERMIERM,NIGHOGHOSSIANN.Contributionof susceptibility-weighted imaging to acute stroke assessment[J]. Stroke, 2004, 35(8):1989-1994.
[11]BAI Y, LIN Y, ZHANG W, et al. Noninvasive amide proton transfer magnetic resonance imaging in evaluating the grading and cellularity of gliomas[J]. Oncotarget, 2017, 8(4):5834-5842.
[12]XU J, XU H, ZHANG W, et al. Contribution of susceptibilityand diffusion-weighted magnetic resonance imaging for grading gliomas[J]. Exp Ther Med, 2018, 15(6):5113-5118.
[13]KONDZIOLKAD,BERNSTEINM,RESCHL,eta1.Significance of hemorrhage into brain tumors:clinicopathological study[J]. J Neurosurg, 1987, 67(6):852-857.
[14]ZHANG J L, SIGMUND E E, RUSINEK H, et al. Optimization of b-value sampling for diffusion-weighted imaging of the kidney[J]. Magn Reson Med, 2012, 67(1):89-97.
[15]BISDAS S, KOH T S, RODER C, et al. Intravoxel incoherent motion diffusion-weighted MR imaging of gliomas:feasibility of the method and initial results[J]. Neuroradiology, 2013,55(10):1189-1196.
[16]BAI Y, LIN Y, TIAN J, et al. Grading of gliomas by using monoexponential, biexponential, and stretched exponential diffusion-weighted MR imaging and diffusion kurtosis MR imaging[J]. Radiology, 2016, 278(2):496-504.
[17]TOGAOO,HIWATASHIA,YAMASHITAK,etal.Differentiation of high-grade and low-grade diffuse gliomas by intravoxel incoherent motion MR imaging[J]. Neuro Oncol,2016, 18(1):132-141.