体素内相位不相干运动成像在高级别胶质瘤及单发转移瘤鉴别中的价值  

Application of intravoxel incoherent motion imaging in differential diagnosis between high-grade gliomas and solitary brain metastasis

作　　者：尤慧明 鲍凯凯 李超 颜力 姚灵君 YOU Huiming;BAO Kaikai;LI Chao;YAN Li;YAO Lingjun(Department of Radiology,Linping District First People's Hospital,Hangzhou 311100,China)

机构地区：[1]杭州市临平区第一人民医院放射科,311100

出　　处：《浙江医学》2021年第19期2114-2117,I0007,共5页Zhejiang Medical Journal

摘　　要：目的探讨体素内相位不相干运动成像(IVIM)在高级别胶质瘤(HGG)及单发转移瘤(SBM)鉴别中的价值。方法收集2017年8月至2021年2月杭州市临平区第一人民医院经手术、活检病理检查、临床病史证实的32例HGG及22例SBM患者,进行常规MR平扫、多个b值IVIM扩散成像及增强扫描。测量肿瘤实质区及瘤周水肿区扩散系数(D值)、假扩散系数(D^(*))及灌注分数(f值),以对侧正常白质(NAWM)作为参照将各参数标准化,采用两样本t检验对各参数进行统计学分析,并采用ROC曲线计算各参数诊断的AUC值、灵敏度和特异度。结果两组患者肿瘤实质区IVIM参数在标准化前后差异均无统计学意义(均P>0.05),而在瘤周水肿区,HGG的D^(*)值、fD^(*)值均高于SBM(均P<0.05),D值低于SBM(P<0.05),而f值差异无统计学意义(P>0.05)。其中,D^(*)值具有最高的鉴别诊断效能,其AUC值、灵敏度和特异度分别为0.914、0.875和0.834。结论肿瘤实质区的IVIM参数无法区别HGG及SBM,而瘤周水肿区的D^(*)值及D值对HGG及SBM有鉴别诊断价值。Objective To evaluate the application of intravoxel incoherent motion imaging(IVIM)in differential diagnosis between high-grade glioma(HGG)and solitary brain metastasis(SBM).Methods From August 2017 to February 2021,32 patients with HGG and 22 patients with SBM confirmed by surgical pathology or clinical history in Hangzhou Linping District First People's Hospital were enrolled in the study.All patient underwent routine MRI scan,multi-b value IVIM diffusion imaging and enhanced MRI scan.The diffusion coefficient D value,the perfusion-related diffusion coefficient D^(*)and the perfusion fraction f value of the tumor parenchymal area and the peritumoral edema area were measured.The contralateral normal white matter(NAWM)was used as a reference to standardize each parameter,and a two-sample t test was used for statistical analysis.ROC curve was used to calculate the area under the curve(AUC)value,sensitivity and specificity of each parameter for differential diagnosis between HGG and SBM.Results There was no statistically significant difference in the IVIM parameters of the tumor parenchymal area between the two groups before and after standardization(all P>0.05),while in the peritumoral edema area,the D^(*)and fD^(*)values of HGG were higher than those of SBM(all P<0.05),D values were lower than that of SBM(P<0.05),while there was no significant difference in f values between two groups.Among all parameters,D^(*)value has the highest differential diagnosis performance,and its AUC value,sensitivity and specificity were 0.914,0.875 and 0.834,respectively.Conclusion The IVIM parameters of the parenchymal area of the tumor could not distinguish between HGG and SBM,however,the D^(*),D and fD^(*)values of the peritumoral edema area have value in differential diagnostic between HGG and SBM.

关 键 词：高级别胶质瘤 单发转移瘤 体素内相位不相干运动成像 

分 类 号：R739.41[医药卫生—肿瘤]