体素内不相干运动扩散加权成像评估脑胶质瘤细胞增殖能力的价值  

Quantitative evaluation of intravoxel incoherent motion diffusion-weighted imaging in proliferation of brain gliomas

作　　者：孙满意[1] 董海波[1] SUN Man-yi;DONG Hai-bo(Department of Radiology, Li Huili Hospital of the Ningbo Medical Center, Ningbo, Zhejiang 315040, China)

机构地区：[1]宁波市医疗中心李惠利医院放射科

出　　处：《中华全科医学》2019年第7期1174-1177,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2017KY572);宁波市科技局第二批科技项目(2016C51017)

摘　　要：目的探讨体素内不相干运动扩散加权成像(IVIM-DWI)评估脑胶质瘤细胞增殖能力(Ki-67LI)的价值。方法回顾性分析2016年12月-2018年6月经手术病理证实的42例脑胶质瘤患者,术前均行颅脑MRI常规扫描、IVIM-DWI,测量肿瘤实性区域的真性水分子扩散系数(D)、微循环灌注系数(D*)和灌注分数(f)。采用Spearman法分析3组定量参数与Ki-67LI之间相关性。利用秩和检验(Mann-Whitney U检验)比较高、低级别组间3个定量参数及其Ki-67LI的差异。ROC曲线评估3个定量参数在脑胶质瘤分级中的诊断效能。结果 D、f与Ki-67LI呈中度负相关,相关系数r分别为-0.514、-0.462(均P<0.05);D*与Ki-67LI无明显相关性(P=0.573)。胶质瘤高级别组D、f的中位值低于低级别组,D*和Ki-67LI高于低级别组,差异均有统计学意义(均P<0.05)。D、D*和f鉴别高、低级别胶质瘤的曲线下面积(AUC)分别为0.963、0.745和0.841,均P<0.05。结论 D、f可用于定量预测脑胶质瘤细胞增殖能力,IVIM-DWI有助于脑胶质瘤的分级评估,以D值诊断效能最高。Objective To investigate the value of quantitative parameters derived from intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI) in proliferation(Ki-67 LI) of brain gliomas. Methods A retrospective analysis of 42 cases of gliomas confirmed by surgical pathology from December 2016 to June 2018 were performed. All patients underwent conventional magnetic resonance imaging(MRI) and IVIM-DWI before operation, then measured the true water diffusion coefficient(D),microcirculation perfusion coefficient(D*) and perfusion fraction(f) in the tumor solid area. Spearman’ s correlation was used to analyze the correlation between the quantitative parameters and Ki-67 LI. Those parameters and the Ki-67 LI were compared between the low-and high-grade gliomas with Mann-Whitney U test. The ROC curve was used to assess the diagnostic efficacy of parameters in the grading assessment of gliomas.Results There was a moderate negative correlation between D, f and Ki-67 LI(r=-0.514,-0.462, P<0.05). There was no significant correlation between D* and Ki-67 LI(P=0.573). The D and f of the high-grade gliomas were lower than those of the low-grade gliomas, whereas D* and Ki-67 LI were higher(P<0.05). The area under the curve(AUC) for identifying high-and low-grade gliomas by D, D* and f was 0.963, 0.745, and 0.841, respectively(P<0.05). Conclusion D and f can be used for quantitative prediction of proliferation. IVIM-DWI is helpful in the grading assessment of gliomas, and the diagnostic efficiency of D is the highest.

关 键 词：胶质瘤 磁共振成像 体素内不相干运动 KI-67标记指数 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]