IVIM在预测高级别脑胶质瘤MGMT启动子甲基化状态的应用价值  

Application value of IVIM in predicting MGMT promoter methylation status in high-grade gliomas

作　　者：田博闻 杨国强 秦江波[2] 张辉[2] TIAN Bowen;YANG Guoqiang;QIN Jiangbo;ZHANG Hui(College of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Radiology,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学院,太原030001 [2]山西医科大学第一医院影像科,太原030001

出　　处：《磁共振成像》2020年第7期506-510,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的研究体素内不相干运动(intravoxel incoherent motion,IVIM)在预测高级别脑胶质瘤O6^-甲基鸟嘌呤-DNA甲基转移酶(O6-methylguanine-DNA methyltransferase,MGMT)启动子甲基化状态的应用价值。材料与方法收集经病理证实的34例高级别脑胶质瘤患者,其中包括WHOⅢ级19例,Ⅳ级15例,术前均行颅脑常规磁共振成像(magnetic resonance imaging,MRI)扫描及IVIM扫描,测量肿瘤实质区域及对侧正常脑组织区域,获得真扩散系数(true diffusion coefficient,D)、灌注相关扩散系数(perfusion related diffusion coefficient,D^*)、灌注分数(perfusion fraction,f),将肿瘤实质区测量值除以对侧正常脑实质区,得到校正后参数值:相对D(relative D)、相对D^*(relative D^*)、相对f(relative f),应用两独立样本t检验分析MGMT启动子甲基化组与非甲基化组间校正参数的差异,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线计算阈值、敏感性及特异性。结果高级别脑胶质瘤MGMT启动子甲基化组中rD、rf值高于非甲基化组,rD^*值低于非甲基化组,差异均有统计学意义(P<0.05)。rD、rD^*、rf值的ROC曲线下面积分别为:0.856、0.814、0.719;阈值分别为:1.703、1.058、1.756;敏感度分别为:84.2%、89.5%、63.2%;特异度分别为:73.3%、60.0%、93.3%。结论IVIM能无创地评估高级别脑胶质瘤MGMT启动子甲基化状态,其中rD^*的灵敏度较高,有助于指导患者的个性化诊治方案以及对预后的评估。Objective:Studies on intramoxin incoherent motion(IVIM)in predicting methylation of the high-grade glioma O6^-methylguanine-DNA methyltransferase(MGMT)promoter application value of status.Materials and Methods:Thirty-four patients with high-grade glioma confirmed by pathology were collected,including 19 cases of WHOⅢand 15 cases ofⅣ.All patients underwent conventional craniocerebral MRI scans and IVIM scans before surgery.Tissue area,obtain true diffusion coefficient(D),perfusion related diffusion coefficient(D^*),perfusion fraction(f),and divide the measured value of the tumor parenchyma by the normal brain on the opposite side In the substantial area,the corrected parameter values are obtained:relative D(relative D),relative D^*(relative D^*),and relative f(relative f).Two-sample independent t test is used to analyze the methylation group and non-methyl group of the MGMT promoter.The correction parameter differences between the groups were calculated,and receiver operating characteristic(ROC)curves were plotted to calculate the threshold,sensitivity,and specificity.Results:The rD and rf values of MGMT promoter methylation group in high-grade glioma was higher than that in non-methylation group,and rD^*value were lower than those in non-methylation group.The differences were statistically significant(P<0.05).The area under the ROC curve of rD,rD^*,and rf values are:0.856,0.814,and 0.719;the thresholds are:1.703,1.058,and 1.756;the sensitivities are:84.2%,89.5%,and 63.2%;the specificities are:73.3%,60.0%,93.3%.Conclusions:IVIM can non-invasively evaluate the methylation status of MGMT promoter in high-grade gliomas.Among them,rD^*has high sensitivity,which can help guide patients'personalized diagnosis and treatment programs and assess prognosis.

关 键 词：神经胶质瘤 磁共振成像 DNA修复酶类 预测 鉴别诊断 

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]