脑胶质瘤的表观扩散系数值与其病理分级的相关性研究  

Correlation between apparent diffusion coefficient values and histopathological grading of cerebral gliomas

作　　者：彭令荣[1] 孔庆聪[1] 江婷[1] 康庄[1] 陈健宁[2] 邹艳[1] Peng Lingrong Kong Qingcong Jiang Ting Kang Zhuang Chen Jianning Zou Yan(Department of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China Department of Pathology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China)

机构地区：[1]中山大学附属第三医院放射科,广州510630 [2]中山大学附属第三医院病理科,广州510630

出　　处：《中华神经医学杂志》2017年第10期1041-1045,共5页Chinese Journal of Neuromedicine

基　　金：广东省科技计划重大专项课题（2014B020225007）

摘　　要：目的探讨脑胶质瘤的表观扩散系数（ADC）值与其病理分级的相关性。方法回顾性收集中山大学附属第三医院神经外科自2013年4月至2016年12月收治的经病理证实的76例脑胶质瘤患者的临床资料，并根据2016 WHO中枢神经系统肿瘤分类标准分为低分级组（Ⅰ、Ⅱ级）（n=21）、中分级组（Ⅲ级）（n=23）、高分级组（Ⅳ级）（n=32）。患者术前均行头颅MRI平扫、增强扫描和弥散加权成像（DWI）检测脑胶质瘤的ADC值，术后均行病理学检查明确病理分级。采用单因素方差分析比较不同病理分级脑胶质瘤间ADC值的差异，采用Spearman秩相关性分析脑胶质瘤的病理分级与ADC值的相关性，采用受试者工作特征曲线（ROC）评价脑胶质瘤的ADC值对高分级脑胶质瘤、低分级脑胶质瘤的诊断效能。结果低分级组、中分级组、高分级组脑胶质瘤的ADC值分别为（1.37±0.26）×10^-3 mm^2/s、（0.97±0.11）×10^-3 mm^2/s、（0.75±0.13）×10^-3 mm^2/s，组内两两比较差异均有统计学意义（P〈0.05）。脑胶质瘤的ADC值与病理分级呈显著负相关关系（r=-0.868，P=0.000）。ROC曲线分析显示ADC值诊断高分级脑胶质瘤的最佳临界点值为0.93×10^-3 mm^2/s，相应的敏感度与特异度分别为81.8%、93.7%；诊断低分级脑胶质瘤的最佳临界点值为1.11×10^-3 mm^2/s，相应的敏感度与特异度分别为95.2%、96.4%。结论ADC值在预判脑胶质瘤的病理分级方面有一定价值。ObjectiveTo investigate the relationship between apparent diffusion coefficient （ADC） values and histopathological grading of cerebral gliomas.MethodsA retrospective analysis was performed to investigate the clinical data of 76 patients with cerebral gliomas, admitted to our hospital from April 2013 to December 2016. According to Classification Criteria of Central Nervous System Tumors by WHO in 2016, these 76 patients were divided into low grade cerebral glioma group （grading I-II, n=21）, moderate grade cerebral glioma group （grading III, n=23） and high grade cerebral glioma group （grading IV, n=32）. MR imaging, enhanced MR imaging and diffusion weighted imaging （3.0T, b value： 1000 s/mm2） were performed to detect the ADC values. One-way ANOVA was used to compare ADC values between the 3 different histopathological groups. Spearman correlation analysis was used to analyze the correlation between histopathological grading of cerebral gliomas and ADC values. A receiver operating characteristic curve （ROC） analysis was performed to evaluate the diagnostic efficiency of ADC values.ResultsThe ADC values of low grade, moderate grade and high grade cerebral gliomas were （1.37±0.26）×10^-3 mm^2/s, （0.97±0.11）×10^-3 mm^2/s, （0.75±0.13）×10^-3 mm^2/s, respectively; statistically significant differences were observed between each two groups （P〈0.05）. There was a negative correlation between ADC values and histopathological grading of cerebral gliomas （r=-0.868, P=0.000）. ROC analysis showed that the optimal cutoff point of ADC values was 1.11×10^-3 mm^2/s in diagnosing low grade cerebral gliomas, enjoying sensitivity and specificity of differential diagnosis of 95.2% and 96.4%; ROC curve showed that the optimal cutoff point of ADC values was 0.93×10^-3 mm^2/s in diagnosing high cerebral gliomas, enjoying sensitivity and specificity of differential diagnosis of 81.8% and 93.7%.ConclusionADC values are important for predicting histopathological grading of cerebral gliomas

关 键 词：神经胶质瘤 表观扩散系数 磁共振成像 弥散加权成像 病理学 

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]