ADC三维直方图分析对胶质瘤IDH1基因突变的预测研究  

ADC-Based Three-Dimensional Histogram Analysis in Prediction of IDH1 Gene Mutation in Glioma

作　　者：邓凯吉 郑晴予 范淑萍 伍文宁 崔敏婕 葛欣宇 郭以欣 蒋日烽[1] DENG Kaiji;ZHENG Qingyu;FAN Shuping(Department of Radiology,Fujian Medical University Union Hospital,Fuzhou,Fujian Province 350001,P.R.China)

机构地区：[1]福建医科大学附属协和医院放射科,福州350001 [2]福建医科大学临床医学部,福州350101

出　　处：《临床放射学杂志》2021年第5期864-869,共6页Journal of Clinical Radiology

基　　金：福建省卫生计生科研人才培养项目(编号:2018-1-37);福建省自然科学基金项目(编号:2018J05135)。

摘　　要：目的探讨基于表观扩散系数(ADC)三维直方图分析在预测胶质瘤异柠檬酸脱氢酶1(IDH1)基因突变状态中的价值。方法回顾性分析本院经手术病理证实的87例胶质瘤患者的MRI和临床资料,其中IDH1突变型31例,野生型56例。所有患者术前行平扫加增强结构MRI及扩散加权成像(DWI),术后对病灶进行IDH1突变状态的检测。采用ImageJ软件,逐层勾画肿瘤实质部分边界,将各层感兴趣区(ROI)组成三维的感兴趣容积(VOI),测量VOI的直方图参数,包括平均值、最大值、最小值、ADC10th、ADC20th、ADC30th、ADC40th、ADC50th、ADC60th、ADC70th、ADC80th、ADC90th、ADC峰度和ADC变异系数。采用Mann-Whitney U检验比较IDH1突变型和野生型间各项直方图参数值的差异,进一步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。结果对于所有级别胶质瘤,IDH1突变型中病灶的ADC10th、ADC20th、ADC30th、ADC40th、ADC50th、ADC60th、ADC70th、ADC80th和平均值均显著高于野生型(P<0.05),其中ADC20th具有最大的曲线下面积(AUC)(0.695),最佳的诊断灵敏度和特异度分别为74.19%和62.50%。对于Ⅱ和Ⅲ级(较低级别)胶质瘤,IDH1突变型中病灶的ADC20th、ADC30th、ADC40th显著高于野生型(P<0.05)。ADC20th具有最大的AUC(0.678),最佳的诊断灵敏度和特异度分别为85.71%和53.57%。结论基于ADC的三维直方图分析可用于预测胶质瘤的IDH1突变状态,其中以ADC20th的诊断效能较好。Objective To explore the value of ADC-based three-dimensional histogram analysis in predicting the IDH1 gene mutation status in glioma. Methods The MRI and clinical data of 87 glioma patients confirmed by pathology in our hospital were retrospectively analyzed, including 31 cases in IDH1 mutation group and 56 cases in wild-type group. All patients underwent structural MRI and DWI before surgery, and IDH1 mutation status was detected after surgery. ImageJ was used to delineate the boundary of the solid tumor slice by slice, and the ROIs of each slice were merged into a three-dimensional VOI. The histogram parameters of the VOI were measured, including average, maximum, minimum, ADC10 th, ADC20 th, ADC30 th, ADC40 th, ADC50 th, ADC60 th, ADC70 th, ADC80 th, ADC90 th, ADCkurtosis and ADCvariation. The Mann-Whitney U test was used to compare the differences of the histogram parameter values between the IDH1 mutation group and the wild-type group, and the receiver operating characteristic(ROC) curve was further applied to determine the optimal threshold, the corresponding sensitivity and specificity. Results up(P<0.05),among which ADC20 th had the highest AUC(0.695),and the best diagnostic sensitivity and specificity were 74.19% and 62.50%,respectively. For grade Ⅱ and Ⅲ(lower grade) gliomas, the ADC20 th, ADC30 th, and ADC40 th of the lesions in the IDH1 mutation group were significantly higher than those in the wild-type group(P<0.05). ADC20 th has the highest AUC(0.678),and the best diagnostic sensitivity and specificity were 85.71% and 53.57%,respectively. Conclusion ADC-basedthree-dimensional histogram analysis can be used to predict the IDH1 mutation status of gliomas, and ADC20 th has best diagnostic performance.

关 键 词：胶质瘤 异柠檬酸脱氢酶1基因 突变 直方图分析 

分 类 号：R739.4[医药卫生—肿瘤]