对比单指数、双指数及拉伸指数DWI鉴别诊断胶质母细胞瘤术后复发与假性进展  

Comparison of DWI based on monoexponential, biexponential and stretched-exponential models in differentiating tumor recurrence and pseudoprogression of glioblastoma

作　　者：廖旦 刘远成 唐斌[1] 王頔 李小海[1] 代斌 王荣品[1] LIAO Dan;LIU Yuancheng;TANG Bin;WANG Di;LI Xiaohai;DAI Bin;WANG Rongpin(Department of Radiology,Guizhou Provincial People's Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院放射科,贵州贵阳550002

出　　处：《中国医学影像技术》2019年第10期1450-1455,共6页Chinese Journal of Medical Imaging Technology

基　　金：贵州省科技支撑项目([2019]2810);贵州省科技计划项目([2016]1096)

摘　　要：目的探讨单指数、双指数及拉伸指数模型体素内不相干运动(IVIM)DWI鉴别胶质瘤术后复发及假性进展的价值。方法根据随诊或二次手术结果将38例接受手术和术后同步放化疗的胶质母细胞瘤患者分为术后复发组(n=20)和假性进展组(n=18)。行IVIM DWI扫描,分别测量病灶的单指数模型参数(ADC)、双指数模型参数[真扩散系数(D)、伪扩散系数(D)、灌注分数(f)]和拉伸指数模型参数[分布扩散系数(DDC),拉伸因子(α)],比较2组间各参数的差异,并绘制ROC曲线,评价各参数对胶质母细胞瘤术后复发及假性进展的诊断效能。结果胶质母细胞瘤术后复发组ADC、D、DDC、α值均小于假性进展组,D、f值均大于假性进展组,差异均有统计学意义(P均<0.05)。ADC、D、D、f、DDC、α诊断胶质母细胞瘤术后复发与假性进展的ROC曲线AUC分别为0.908、0.925、0.804、0.743、0.901和0.961。结论单指数、双指数及拉伸指数模型相关参数对于胶质母细胞瘤术后复发及假性进展均具有较高诊断价值,其中拉伸指数模型中α值诊断效能更好。Objective To investigate the value of parameters derived from monoexponential,biexponential and stretched exponential intravoxel incoherent motion(IVIM)DWI models in differentiating tumor recurrence and pseudoprogression in patients with glioblastoma.Methods Totally 38 patients with pathologically confirmed glioblastoma after surgery,chemotherapy and radiation therapy were enrolled and divided into tumor recurrence group(n=20)and pseudoprogression group(n=18)according to follow-up or reoperation results.IVIM DWI was performed,and the parameters of monoexponential model(ADC),biexponential model(true molecular diffusion coefficient[D],pseudo-diffusion coefficient[D],perfusion fraction[f])and stretched exponential model(distributed diffusion coefficient[DDC],stretched index[α])were measured and compared between the 2 groups.ROC curve was used to analyze the efficacy of these parameters in differentiating tumor progression and pseudoprogression.Results ADC,D,DDC andαvalues were significantly lower in tumor recurrence group than those in pseudoprogression group,while D and f were significantly higher than those in pseudoprogression group(all P<0.05).ROC curve analysis showed AUC of ADC,D,D,f,DDC andαvalue for differentiating tumor recurrence and pseudoprogression was 0.908,0.925,0.804,0.743,0.901 and 0.961,respectively.Conclusion Parameters derived from monoexponential,biexponential and stretched exponential IVIM models have great value in differentiating tumor recurrence from pseudoprogression in patients with glioblastoma,andαfrom stretched exponential model has higher efficacy.

关 键 词：胶质母细胞瘤 肿瘤复发 局部 假性进展 体素内不相干运动 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]