微血管管径成像技术对少突胶质细胞瘤分级的价值  

The value of vessel size imaging of microvasculatures in grading of oligodendroglioma

作　　者：郭虹[1] 康厚艺[1] 谭勇[1] 吴昊[1] 张伟国[1] Guo Hong Kang Houyi Tan Yong Wu Hao Zhang Weiguo(Department of Radiology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing 400042, Chin)

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科重庆市影像医学与核医学临床医学研究中心,400042

出　　处：《中华放射学杂志》2017年第4期262-267,共6页Chinese Journal of Radiology

基　　金：国家自然科学基金（81571660）;重庆市国际科技合作基金（cstc2014自hz110002）;第三军医大学大坪医院野战外科研究所临床科研基金（2014YLC03）

摘　　要：目的 采用微血管管径成像技术探讨微血管管径指数（VSI）在Ⅱ、Ⅲ级少突胶质细胞瘤（OG）分级中的价值.方法 回顾性分析经手术证实的OG 24例,Ⅱ级13例、Ⅲ级11例.患者均先行常规MRI,再行梯度回波-自旋回波动态磁敏感对比增强灌注扫描得到VSI图,用热点法分析并测量肿瘤区VSI平均值（VSImean）、VSI最大值（VSImax）.对患者石蜡切片行CD34染色得组织学血管管径（VShis）.将VSImean、VSImax分别与VShis行Pearson相关性分析.再用两个独立样本非参数检验（Mann-Whitney U检验）比较Ⅱ、Ⅲ级少突胶质瘤VShis、VSImean、VSImax差异.应用ROC曲线评估VShis、VSImean、VSImax对Ⅱ、Ⅲ级OG的鉴别价值.结果 VSImean、VSImax均与VShis具有明显相关性（r值分别为0.738、0.705,P〈0.05）.Ⅱ、Ⅲ级OG VSImean分别为38.93（17.96-81.18）、91.49（36.94-144.68）μm,VSImax分别为45.12（22.30-89.65）、121.19（57.29-164.00）μm,VShis分别为8.51（5.25-12.76）、11.03（7.59-21.96）μm;Ⅱ、Ⅲ级OG VSImean、VSImax、VShis差异均有统计学意义（Z值分别为-3.505、-3.911、-2.729,P〈0.05）.ROC结果显示在鉴别Ⅱ级、Ⅲ级OG中,VSImean最佳临界值、敏感度、特异度及AUC分别为52.58μm、90.91%、92.31%、0.923,VSImax分别为81.18μm、90.91%、100.00%、0.972,VShis分别为9.01μm、90.00%、84.62%、0.838.结论 VSI可较为准确地评估OG微血管管径,并能够鉴别Ⅱ、Ⅲ级OG,对术前鉴别OG级别提供了可靠的信息.Objective To investigate the value of vessel size index（VSI） in grading oligodendroglioma by vessel size imaging technique. Methods Twenty-four histologically confirmed oligodendroglioma cases were enrolled （13 gradeⅡand 11 gradeⅢ） . All patients underwent conventional MRI scanning, followed by multi gradient-echo spin-echo sequence from dynamic susceptibility contrast perfusion to generate VSI maps. Region of interests were contoured on VSI color maps to obtain hot-spot value of mean VSI of microvasculature （VSImean） and maximum VSI of microvasculature （VSImax）. Paraffin sections of each case was stained with CD34 to acquire microvascular caliber （VShis）. Pearson correlation analysis was used to evaluate the correlation between VSImean, VSImax and VShis respectively. Mann-Whitney U test was used to compare VSImean, VSImax and VShis between grade Ⅱ and Ⅲ oligodendrogliomas. ROC analysis was performed to assess the effectiveness of VSImean, VSImax and VShis in grading oligodendrogliomas. Results Both VSImean and VSImax were strongly correlated with VShis （r=0.738, 0.705,P〈0.05）. For gradeⅡand Ⅲ oligodendrogliomas, VSImean were 38.93（17.96 to 81.18）μm and 91.49（36.94 to 144.68）μm, VSImax were 45.12（22.30 to 89.65）μm and 121.19（57.29 to 164.00）μm, VShis were 8.51（5.25 to 12.76）μm and 11.03（7.59 to 21.96）μm respectively. VSImean, VSImax, and VShis showed significant difference （Z=-3.505,-3.911, -2.729,P〈0.05） between grade Ⅱ and Ⅲ oligodendrogliomas. ROC analysis revealed that the optimal cutoff value, sensitivity, specificity and AUC of VSImean was 52.58 μm, 90.91%, 92.31%, 0.923 respectively, 81.18μm, 90.91%, 100.00%, 0.972 for VSImax, and 9.01μm, 90.00%, 84.62%, 0.838 for VShis respectively. Conclusions Vessel size imaging derived VSI correlated well with histopathology. It could provide valuable information in the pre-operative grading of oligodendroglioma.

关 键 词：神经胶质瘤 微血管 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]