DTI定量参数对胶质瘤分级与肿瘤增殖活性的评价  

Evaluation of DTI Parameters for Glioma Grading and Correlation with Tumor Proliferation

作　　者：蒋玲[1,2] 姚振威[1] 冯晓源[1] 汪寅[3] 蒋胜洪[1] 杨忠[1] 

机构地区：[1]复旦大学附属华山医院放射科 [2]海交通大学附属中国福利会国际和平妇幼保健院放射科 [3]复旦大学附属华山医院病理科

出　　处：《中国医学计算机成像杂志》2013年第2期106-110,共5页Chinese Computed Medical Imaging

基　　金：国家自然科学基金(No.39070805)~~

摘　　要：目的:评价DTI定量参数与胶质瘤分级、Ki-67标记指数相关性。方法:回顾性分析39例手术病理证实为幕上胶质瘤患者的MR和免疫组化结果。分别测量肿瘤实质和对侧正常组织ADC值和FA值并计算相应比值后作统计学分析。结果:ADC值/比值,FA值/比值和Ki-67标记指数在高低级别组差异有统计学意义。WHO 2级组ADC值/比值分别与WHO 3级和WHO 4级组差异有统计学意义,WHO 3、4级之间差异无统计学意义。FA值/比值在WHO 2、3、4级组间差异无统计学意义。WHO 4级Ki67标记指数与WHO 2级和WHO 3级组差异均有统计学意义,但WHO 2、3级之间差异无统计学意义。经ROC分析得出ADC值和比值对胶质瘤分级具有中等诊断价值,临界值分别为1202.05×10-6mm2/s和1.57,灵敏度达83.3%,83.3%,特异度达83.3%,81.5%。ADC值/比值与Ki-67标记指数呈显著负相关(r分别为-0.585和-0.591,P<0.01),FA值/比值只有弱正相关(r=0.320,P<0.05)。结论:DTI定量参数测量有助于胶质瘤分级,尤其是ADC值和比值能反映肿瘤增殖活性,无创性地预测患者预后。Purpose： To assess the correlation between DTI parameters, glioma grading and Ki-67 labeling index （LI）. Methods： MR and pathological findings from 39 patients with pathologically proved supratentorial gliomas were retrospectively evaluated. FA and ADC values were measured in 2 regions （tumor solid portion and contralateral normal tissue）. We compared mean FA and ADC values/ratios between low- and high- grade gliomas and among WHO 2-4 groups. The correlation among FA and ADC values/ratios and Ki-67 LI were also investigated. Results： In high-grade gliomas, ADC values/ratios and Ki-67 LI were significantly different from those of low-grade gliomas, but FA values or ratios were slightly different. ADC values or ratios for grade 2 versus grade 3 and grade 2 versus 4 were significantly different. Ki-67 LI for grade 2 versus grade 4 and grade 3 versus grade 4 were significantly different. The cutoff values of 1202.05×10- 6mm^2/s and 1.57 for mean ADC value and ratio in differentiating low- from high-grade gliomas provided the best combination of sensitivity （83.3%, 83.3%） and specificity（83.3%, 81.5%）. Mean ADC values/ratios had a significantly negative correlation with Ki-67 LI （r= -0.585 and -0.591, P〈0.01）. Slight positive correlation was observed between the Ki-67 LI and FA ratios （r=0.320, P〈0.05）. Conclusion： Measurements of DTIparameters have a potential for glioma grading and the mean ADC values or ratios can provide additional information about glioma proliferation related to patient＇ s prognosis.

关 键 词：胶质瘤 弥散张量成像 肿瘤增殖 

分 类 号：R739.4[医药卫生—肿瘤]