常规MR征象在鉴别单发大脑胶质瘤级别中的价值  

Value of conventional MRI features in solitary cerebral glioma grading

作　　者：王蓉[1] 郑婕[2] 杜永浩[1] 刘哲[1] 杨健[1] 

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]西安交通大学第一附属医院临床研究中心,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2017年第6期866-871,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家重点研发计划项目(No.2016YFC0100300);国家自然科学基金项目(No.81471631;81171317;81201134);2011年教育部"新世纪优秀人才支持计划"(No.NCET-11-0438);西安交通大学第一附属医院临床研究课题重点项目(No.XJTU1AF-CRF-2015-004)~~

摘　　要：目的评估单发大脑胶质瘤常规核磁共振(MR)检查征象在评价大脑胶质瘤高低级别中的价值。方法回顾性分析有手术病理结果的218例单发大脑胶质瘤患者,分为低级别组(134例)和高级别组(84例)。采用t检验、卡方检验和逻辑回归分析评价患者年龄、性别及MR征象(包括接触脑室下区(subventricular zone,SVZ)、不均匀性、肿瘤边界、坏死囊变、出血、跨越中线、占位效应、水肿程度、强化体积、强化不均匀性)在高低级别胶质瘤组间差异及相关性。结果高、低级别胶质瘤组间,年龄有统计学差异(P<0.001),性别未见统计学差异(P=0.864)。在MR征象中,接触SVZ(P=0.011)、肿瘤不均匀性(P<0.001)、坏死囊变(P=0.037)、水肿程度(P=0.017)、占位效应(P=0.009)、肿瘤边界(P<0.001)以及强化体积(P<0.001)在两组间有统计学差异。多因素逻辑回归分析显示,年龄、肿瘤坏死囊变、肿瘤边界以及强化程度是高级别胶质瘤的阳性预测值。结论常规MR征象可用于鉴别大脑胶质瘤的高低级别;患者年龄越大、肿瘤坏死囊变越严重、肿瘤边界不清和强化体积越大的,为高级别胶质瘤的可能性越大。Objective To evaluate the value of conventional MRI in determining high-or low-grade solitary cerebral glioma.Methods We divided 218 patients with solitary cerebral glioma confirmed by surgical pathology into low-grade group（n=134）and high-grade group（n=84）.MRI features include the following：in contact with subventricular zone（SVZ）,tumor heterogeneity,tumor boundary,necrosis,hemorrhage,crossing midline,occupying effect,peritumoral edema,volume of enhancement,and enhanced inhomogeneity.The t-test,chi-square test and logistic regression analysis were used to evaluate the differences in age,gender and magnetic resonance imaging between the high-and low-grade glioma groups.MRI findings were then correlated with grade of gliomas.Results There was a significant difference in age between the two groups（P〈0.001）.There was no significant difference in men and women between the two groups（P=0.864）.Seven out of ten MRI findings were identified to be significantly different between high-and low-grade groups.They were SVZ contact（P =0.011）,tumor heterogeneity（P〈0.001）,cystic change and necrosis（P=0.037）,degree of edema（P=0.017）,occupying effect（P=0.009）,tumor boundary（P〈0.001）,and volume of enhancement（P〈0.001）.Moreover,the logistic regression analysis indicated that age,cystic change and necrosis,tumor boundary,and volume of enhancement were independently associated with high-grade gliomas.Conclusion Conventional MRI findings are useful in determining high-or low-grade gliomas.Presence of the following MRI features suggests high-grade gliomas：older age,notable cystic changes and necrosis,unclear tumor boundary,and significant enhancement.

关 键 词：核磁共振(MR) 大脑胶质瘤 病理分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R174.1[医药卫生—诊断学]