动态对比增强MRI纹理分析预测高级别胶质瘤IDH基因表型的价值  

The value of textural analysis based on dynamic contrast-enhanced-MRI in predicting IDH genetic phenotypes of high-grade gliomas

作　　者：卢海涛 邢伟 张艳文 董博[2] 吴汝洪 顾正章 Lu Haitao;Xing Wei;Zhang Yanwen;Dong Bo;Wu Ruhong;Gu Zhengzhang(Department of Radiology,First People's Hospital of Changzhou,Changzhou 213003,China;Department of Neurosurgery,First People's Hospital of Changzhou,Changzhou 213003,China)

机构地区：[1]江苏省常州市第一人民影像科,213003 [2]江苏省常州市第一人民医院神经外科,213003

出　　处：《中华放射学杂志》2020年第5期450-455,共6页Chinese Journal of Radiology

基　　金：常州市卫生计生委青年人才科技项目(QN201811)。

摘　　要：目的探讨动态对比增强(DCE)-MRI纹理分析术前鉴别脑高级别胶质瘤异柠檬酸脱氢酶(IDH)基因表型的价值。方法回顾性分析常州市第一人民医院院2016年4月至2019年12月经手术病理证实的、IDH基因型明确的29例高级别胶质瘤,其中IDH突变型10例,IDH野生型19例。采用荷兰飞利浦Achieve 3.0 T超导MR扫描仪进行数据采集,扫描序列包括常规MRI平扫、增强及动态对比增强(DCE)。采用Omni Kinetics软件进行DCE数据分析及纹理分析,生成全脑容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)、血浆容积分数(Vp)及信号强度-时间曲线下面积(AUC)参数图;采用灰度共生矩阵法提取各参数图ROI内5个常用纹理特征(能量、熵、惯性、相关性、逆差矩)。采用独立样本t检验(满足正态分布和方差齐性)或Mann-Whitney秩和检验(不满足正态分布或方差不齐)比较IDH突变组与IDH野生组各参数图纹理特征的差异。对差异有统计学意义的纹理特征绘制受试者操作特征(ROC)曲线,评价其鉴别IDH突变型与IDH野生型高级别胶质瘤的效能。结果IDH突变型高级别胶质瘤Ktrans、Ve的熵分别为5.368±1.458、6.698±1.081,IDH野生型高级别胶质瘤Ktrans、Ve的熵分别为7.334±1.385、8.213±1.320,两组间差异具有统计学意义(t值分别为-3.570、-3.113,P值分别为0.001、0.004)。IDH突变型高级别胶质瘤Ktrans、Ve的逆差距分别为0.567±0.147、0.417±0.106,IDH野生型高级别胶质瘤Ktrans、Ve的逆差距分别为0.393±0.119、0.296±0.101,两组间差异具有统计学意义(t值分别为3.452、3.014,P值分别为0.002、0.006)。Ktrans的熵鉴别IDH突变型与IDH野生型高级别胶质瘤的ROC曲线下面积最大(0.874),对鉴别诊断的灵敏度也最高(100%);Ve的逆差距对鉴别诊断的特异度最高(94.7%)。结论DCE-MRI纹理分析有助于术前高级别胶质瘤IDH基因表型的鉴别。Objective To investigate the value of dynamic contrast-enhanced(DCE)-MRI based textural analysis in differentiating IDH mutated high-grade gliomas from IDH gene wild types.Methods Twenty-nine patients with high grade gliomas collected from April 2016 to December 2019 in First People's Hospital of Changzhou were assessed retrospectively,including 10 patients with IDH mutation and 19 patients with IDH gene wild type.All patients underwent DCE,conventional plain and enhanced MR scanning.Omni Kinetics software was used to perform DCE-MRI data processing,volume transfer constant(Ktrans),ratio constant of tracer refluxing from tissue to plasma(Kep),extravascular extracellular space per unit volume of tissue(Ve),blood plasma volume(Vp)and area under the gadolinium concentration-time curve(AUC)were obtained.Five commonly used textural features,including Energy,Entropy,Inertia,Correlation,and Inver Difference Moment(IDM),were generated based on gray-level co-occurrence matrices.The independent samples t test(normal distributionand equal variance)or Mann-Whitney rank sum test(abnormal distribution or unequal variance)was used to compare the differences in textural features of DCE-MRI parameters between IDH mutated group and IDH gene wild type group.Receiver operating characteristic(ROC)curves were used to evaluate the efficiency of textural features of DCE-MRI parameters in differentiating IDH mutated high-grade gliomas from IDH gene wild types for statistically significant textural features.Results Entropy of Ktrans and Ve for IDH mutated group were 5.368±1.458 and 6.698±1.081,respectively;while the corresponding values were 7.334±1.385 and 8.213±1.320 for IDH gene wild type group,respectively.The difference between the two groups was statistically significant(t values were-3.570,-3.113,P values were 0.001,0.004,respectively).Inverse difference moment of Ktrans and Ve for IDH mutated group were 0.567±0.147 and 0.417±0.106,respectively;while for IDH gene wild type group,the values were 0.393±0.119 and 0.296±0.101,r

关 键 词：神经胶质瘤 磁共振成像 IDH基因突变 

分 类 号：R44[医药卫生—诊断学] R73[医药卫生—临床医学]