氨基质子转移MRI对脑胶质瘤分级及预测肿瘤细胞增殖的诊断价值  

Diagnostic efficacy of amide proton transfer MRI in the grading of gliomas and predicting tumor cell proliferation

作　　者：李欣蓓[1] 宋玉坤[1] 朱筱磊 王玉亮[1] 赵静[1] 严序 王婧妍[1] 初建平[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]西门子医疗东北亚科研合作部

出　　处：《放射学实践》2017年第4期355-359,共5页Radiologic Practice

基　　金：国家自然科学基金青年基金项目(81201074);中央高校基本科研业务费(中山大学青年教师培育计划;13ykpy14)

摘　　要：目的:探讨氨基质子转移(APT)MRI对脑胶质瘤分级的诊断价值及其与肿瘤细胞增殖标记物Ki-67表达水平的相关性。方法:经病理证实的21例脑胶质瘤患者术前行常规MR平扫、增强及APT扫描,其中低级别胶质瘤8例(WHOⅠ~Ⅱ级),高级别胶质瘤13例(WHOⅢ~Ⅳ级)。在肿瘤实质区选取5~10个ROI,测量并计算MTRasym值。采用Mann-Whitney-Wilcoxon检验比较高低级别胶质瘤间MTRasym值的差异,采用Spearman相关分析来分析MTR_(asym)值与肿瘤Ki-67表达水平的相关性。结果:高级别胶质瘤的MTR_(asym)值(4.41%±2.23%)明显高于低级别胶质瘤(3.83%±2.02%),差异有统计学意义(W=5816,Z=-3.01,P<0.05)。高级别胶质瘤的Ki-67的表达水平(38.85%±21.03%)明显高于低级别胶质瘤(4.13%±2.64%),差异有统计学意义(W=2606,Z=-11.54,P<0.05)。胶质瘤的MTRasym值与Ki-67表达水平呈正相关(r=0.25,P<0.001)。结论:MR氨基质子转移成像可用于鉴别高低级别胶质瘤,对预测肿瘤细胞增殖有潜在价值。Objective：To evaluate the diagnostic efficacy of amide proton transfer （APT） MRI in the grading of brain glioma and to study its correlation with the expression of cell proliferation bio-marker （Ki-67） level. Methods： Twenty-one patients with pathology proven brain glioma, including low-grade glioma （LGG,WHO grade Ⅰ-Ⅱ） in 8 patients and high- grade glioma （HGG,WHO grade Ⅲ- Ⅳ ） in 13 patients, underwent routine plain and contrast enhanced MRI as well as APT MRI. Five to ten regions of interest （ROIs） were manually drawn within the tumor parenchyma,the asymmetric magnetization transfer ratio （MTRasym） was calculated and analyzed. Mann-Whitney-Wilcoxon test was used to compare the MTRasym value between LGG and HGG and its correlation with the level of Ki-67 was analyzed using Spearman correlation analysis. Results= The mean value of MTRasym of HGG （4. 41±2. 23%） was significantly higher than that of LGG （a. 8%±2.02%） ,with statistical difference （W=5816,Z= -3.01,P〈0.05） ,and the HGG also showed higher expres- sion level of Ki-67 （38. 85± 21.03%） than that of LGG （4. 13% ± 2. 64）, with statistical difference （W= 2606, Z= 11.54, P〈0.05）. The MTRasym was positively correlated with Ki-67 value （r= 0.25, P〈0.001 ）. Conclusion ： Amide pro- ton transfer MRI might provide helpful information in the differentiation of HGG and LGG,and may have potential signifi- cance in predicting tumor cell proliferation.

关 键 词：脑肿瘤 胶质瘤 氨基质子转移成像 磁共振成像 KI-67 

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]