IVIM-MRI对人脑胶质瘤的病理分级及IDH1基因突变的评估价值  

Value of IVIM-MRI in evaluation of pathological grade and IDH1 gene mutation of human glioma

作　　者：邢士军[1] 王莉 张丽君[1] XING Shi-jun;WANG Li;ZHANG Li-jun(Department of Neurosurgery,The Third Affiliated Hospital of Soochow University(Changzhou First People's Hospital),Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院神经外科,江苏常州213003

出　　处：《中国临床神经外科杂志》2020年第12期821-824,共4页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81302197)。

摘　　要：目的探讨体素不相干运动扩散加权(IVIM)-MRI对人脑胶质瘤的病理分级及异柠檬酸盐脱氢酶1(IDH1)突变的评估价值。方法回顾性分析2016年1月至2019年12月术后病理确诊的100例脑胶质瘤的临床资料。术前应用3.0 T MRI扫描仪检查,获取IVIM-MRI参数,包括灌注比例系数(F)、真实扩散系数(D)、伪扩散系数(D*)与表观扩散系数(ADC)。结果与高级别胶质瘤相比,低级别胶质瘤ADC值与D值明显增高(P<0.05),而F值与D*值均显著降低(P<0.05)。无论是低级别胶质瘤,还是高级别胶质瘤,IDH1基因突变型病人ADC值显著高于IDH1基因突野生型(P<0.05)。高级别胶质瘤病人中,IDH1基因突变型病人F值、D*值均显著低于IDH1基因野生型(P<0.05)。ROC曲线分析显示,对于鉴别胶质瘤级别,ADC值的最佳临界值为1.091,灵敏度为86.92%,特异度为89.45%;D值的最佳临界值为0.934,灵敏度为78.26%,特异度为94.71%;D*值的最佳临界值为6.161,灵敏度为73.95%,特异度为73.66%;F值的最佳临界值为0.190,灵敏度为56.55%,特异度为100.00%。对于区分IDH1基因型,低级别胶质瘤病人中,ADC值区分IDH1基因突变的最佳临界值为1.181,灵敏度为92.87%,特异度为80.01%;高级别胶质瘤病人中,F值的效能最高,灵敏度为100.00%,特异度为92.87%。结论IVIM-MRI定量分析可用于胶质瘤术前诊断与分级,并对预测胶质瘤IDH1基因状态具有潜在意义。Objective To investigate the predictive value of intravoxel incoherent motion(IVIM)-MRI in the evaluation of pathological grade and IDH1 gene mutation of human glioma.Methods A retrospective analysis on the clinical data of 100 patients with glioma diagnosed by postoperative pathological examination from January 2016 to December 2019 was performed.All the patients received IVIM-MRI examination preoperatively using 3.0 T MRI scanner to obtain IVIM-MRI parameters,including perfusion scale coefficient(F),true diffusion coefficient(D),pseudo diffusion coefficient(D*)and apparent diffusion coefficient(ADC).Results The ADC and D values of the low-grade glioma tissues were significantly higher than those of the high-grade glioma tissues(P<0.05),while the F and D*values were significantly lower than those of the high-grade glioma tissues(P<0.05).The ADC values of the low-grade glioma and high-grade glioma tissues with IDH1 gene mutation were significantly higher than those without IDH1 gene mutation(P<0.05).Of high-grade glioma tissues,the F value and D*values of IDH1 gene mutant glioma tissues were significantly lower than those without IDH1 gene mutation(P<0.05).ROC curve analysis showed that,for distinguishing high-grade and low-grade gliomas,the best cut-off value of ADC value was 1.091,with a sensitivity of 86.92%and a specificity of 89.45%;the best cut-off value of the D value was 0.934,with a sensitivity of 78.26%and a specificity of 94.71%;the best cut-off value of the D*value was 6.161,with a sensitivity of 73.95%and a specificity of 73.66%;the best cut-off value of the F value was 0.190,with a sensitivity of 56.55%and a specificity of 100.00%;for distinguishing IDH1 gene mutation in low-grade gliomas,the best cut-off value of the ADC value was 1.181,with a sensitivity of 92.87%and a specificity of 80.01%;for distinguishing IDH1 gene mutation in high-grade gliomas,the F value had the highest efficiency,with a sensitivity of 100.00%and a specificity of 92.87%.Conclusion IVIM-MRI can be used for preoperative diagn

关 键 词：胶质瘤 体素不相干运动扩散加权磁共振成像 术前评估 异柠檬酸盐脱氢酶1 

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]