合成MRI预测胶质瘤异柠檬酸脱氢酶1基因型的价值  

Application of synthetic MRI in predicting isocitrate dehydrogenase 1 genotypes in gliomas

作　　者：葛鑫 杨治花[2] 申颖 刘文潇 翟学峰[4] 马文富 王明磊[5] 张伟[5] 王晓东[5] Ge Xin;Yang Zhihua;Shen Ying;Liu Wenxiao;Zhai Xuefeng;Ma Wenfu;Wang Minglei;Zhang Wei;Wang Xiaodong(Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Department of Radiotherapy,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Rehabilitation Medicine,Second Affiliated Hospital of Air Force Military Medical University,Xi′an 710038,China;Department of Pathology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;the Second Clinical College of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]宁夏医科大学临床医学院,银川750004 [2]宁夏医科大学总医院放疗科,银川750004 [3]空军军医大学第二附属医院康复医学科,西安710038 [4]宁夏医科大学总医院病理科,银川750004 [5]宁夏医科大学总医院放射科,银川750004 [6]兰州大学第二临床医学院,兰州730030

出　　处：《中华医学杂志》2023年第33期2619-2623,共5页National Medical Journal of China

基　　金：宁夏自然科学基金(2022AAC03487)

摘　　要：通过分析2020年8月至2021年9月在宁夏医科大学总医院进行颅脑合成MRI和扩散加权成像(DWI)检查的81例胶质瘤患者的临床及影像资料,探讨合成MRI弛豫定量值预测胶质瘤异柠檬酸脱氢酶1(IDH1)基因型的价值。男44例、女37例,年龄50.0(36.5,59.0)岁。通过勾画感兴趣区的方法获得肿瘤pre-T_(1)、pre-T_(2)、pre-PD、post-T_(1)和表观扩散系数(ADC)值。采用单因素分析比较组间各参数值的差异,受试者工作特征曲线评估各参数值预测胶质瘤IDH1基因型的诊断效能。结果表明IDH1m胶质瘤pre-T_(1)和pre-PD值[M(Q_(1),Q_(3))]均低于IDH1w胶质瘤[1462.75(1306.41,1567.75)ms比1532.83(1434.67,1617.67)ms,84.18(82.28,86.41)pu比85.85(84.65,86.90)pu](均P<0.05),IDH1m胶质瘤post-T_(1)和ADC值高于IDH1w胶质瘤[1054.50(631.92,1262.63)ms比669.67(535.17,823.33)ms,1.20(0.86,1.35)×10^(-3)mm^(2)/s比0.80(0.76,0.93)×10^(-3)mm^(2)/s](均P<0.05),联合模型(pre-T_(1)+pre-PD+post-T_(1)+ADC+年龄)的受试者工作特征曲线下面积(AUC)达到了0.828(95%CI:0.729~0.903)。合成MRI弛豫定量值有助于鉴别胶质瘤IDH1基因型,pre-T_(1)、pre-PD、post-T_(1)、ADC和年龄组建的多参数联合模型诊断效能优于单一参数,可作为提高胶质瘤分子标记物鉴别诊断能力的有效策略。This study analyzed the clinical and imaging data of 81 glioma patients who underwent brain synthetic MRI and diffusion weighted imaging(DWI)examination in the General Hospital of Ningxia Medical University from August 2020 to September 2021 to explore the value of synthetic MRI relaxation quantitative value in predicting the genotype of isocitrate dehydrogenase 1(IDH1)in gliomas.There were 44 males and 37 females,those patients with an aged 50.0(36.5,59.0)years.The tumor pre-T_(1),pre-T_(2),pre-PD,post-T_(1)and ADC values were obtained by outlining the region of interest(ROI).Univariate analysis was used to compare the differences of parameter values between groups,and the receiver operating characteristic was used to evaluate the diagnostic efficacy of each parameter value in predicting glioma IDH1 genotype.The results showed that the pre-T_(1)and pre-PD values[M(Q_(1),Q_(3))]of IDH1m glioma were lower than those of IDH1w glioma[1462.75(1306.41,1567.75)ms vs 1532.83(1434.67,1617.67)ms,84.18(82.28,86.41)pu vs 85.85(84.65,86.90)pu](all P<0.05).The post-T_(1)and ADC values of IDH1m glioma were higher than those of IDH1w glioma[1054.50(631.92,1262.63)ms vs 669.67(535.17,823.33)ms,1.20(0.86,1.35)×10^(-3)mm^(2)/s vs 0.80(0.76,0.93)×10^(-3)mm^(2)/s](all P<0.05).The AUC of the combined model(pre-T_(1)+pre-PD+post-T_(1)+ADC+Age)is 0.828(95%CI:0.729-0.903).Synthetic MRI relaxation quantitative values are helpful to distinguish IDH1 genotypes in glioma.The diagnostic efficacy of the multi-parameter combined model based on pre-T_(1),pre-PD,post-T_(1),ADC,and age is better than that of the single parameter,and it can be used as an effective strategy to improve the differential diagnosis ability of gliomas molecular markers.

关 键 词：放射学 合成磁共振成像 质子密度 胶质瘤 异柠檬酸脱氢酶1基因型 病例系列研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]