基于对比增强T1WI直方图分析预测多形性胶质母细胞瘤IDH1突变状态  

Post-contrast enhanced T1WI histogram analysis in predicting the status of IDH1 mutation in glioblastoma multiforme

作　　者：陈鑫[1] 张国琴 阮秀杭 魏新华[1] CHEN Xin;ZHANG Guo-qin;RUAN Xiu-hang(Department of Radiology,Guangzhou First People′s Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院放射科,广州510180

出　　处：《放射学实践》2020年第4期452-455,共4页Radiologic Practice

基　　金：国家自然科学基金项目(No.81601469);广州市卫生健康科技项目(No.20191A011002);广州市科技计划项目(201804010032)。

摘　　要：目的:探讨基于对比增强T1WI直方图分析在预测多形性胶质母细胞瘤(GBM)IDH1突变状态中的价值。方法:回顾性分析我院经手术病理证实的116例GBM患者的MRI和临床资料,其中IDH1突变组20例,野生型组96例。所有患者术前行T1WI、T2WI、FLAIR和对比增强T1WI扫描,术后对病灶进行IDH1突变状态的检测。采用Image J软件,在肿瘤最大层面的增强T1W图像上于强化的肿瘤实质部分内勾画ROI,测量ROI的直方图参数,包括均数、标准差(SD)、最小值、最大值、中位数、峰度和偏度。采用Mann-Whitney U检验比较IDH1突变组和野生型组间各项直方图参数值的差异,对有统计学差异的直方图参数绘制受试者工作特征(ROC)曲线,确定最佳诊断阈值,并计算相应的敏感度和特异度。结果:IDH1突变组中病灶的均数、最小值、最大值和中位数均大于野生型组,差异均具有统计学意义(P<0.010)。两组间SD、峰度和偏度的差异均无统计学意义(P=0.079~0.527)。均数、最小值、最大值和中位数鉴别IDH1突变状态的ROC曲线下面积分别为0.758、0.729、0.684和0.764,其中均数和中位数的诊断效能较好,分别以118.69和120.50为界值时,敏感度均为0.700,特异度均为0.677。结论:基于对比增强T1WI直方图分析可用于预测GBM的IDH1突变状态,其中以均数和中位数的诊断效能较好。Objective:To investigate the value of post-contrast enhanced T1WI-based histogram analysis in predicting the status of IDH1 mutation in glioblastoma multiforme(GBM).Methods:The MRI data and clinical information of 116 patients with pathologically proven GBM were retrospectively collected.All patients underwent conventional MR examination before surgery,and the IDH1 mutation status was evaluated.The tumor was manually segmented on the tumor largest cross-sectional slice of post-contrast T1WI using Image J software,and the histogram parameters including mean,standard deviation(SD),minimum,maximum,median,kurtosis and skewness,were calculated.The Mann-Whitney U-test was used to compare the differences of histogram parameters between IDH1 mutant and wild-type groups.The receiver operating characteristic(ROC)curve was drawn to evaluate the performance of parameters with statistical difference in predicting the status of IDH1 by calculating sensitivity and specificity.Results:The values of mean,minimum,maximum,and median of IDH1 mutation group were statistically larger than those of the IDH1 wild type group(P<0.010).The values of SD,kurtosis and skewness between two groups did not show significant difference(P=0.079~0.527).The area under the ROC curve of mean,minimum,maximum and median for predicting IDH1 mutation status was 0.758,0.729,0.684 and 0.764,respectively.The good performance was achieved by the parameters of mean and median.The sensitivity and specificity was both 0.700 and 0.677 when the cutoff value of mean and median was 118.69 and 120.50.Conclusion:Post-contrast enhanced T1WI histogram analysis can be used to predict the status of IDH1 mutation in GBM,and the diagnostic efficacy of mean and median is better.

关 键 词：胶质母细胞瘤 异柠檬酸脱氢酶1基因 突变 直方图分析 

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]