高分辨率OCT成像在脑胶质瘤术中定性诊断与边界定位的应用研究  

Application research of high-resolution OCT imaging in qualitative diagnosis and boundary location of brain glioma

作　　者：杨松 杨建凯[1] 戴丽[1] 杨靖祎 王鹏飞[2] 孙晓立[3] 焦保华[1] Yang Song;Yang Jiankai;Dai Li;Yang Jingyi;Wang Pengfei;Sun Xiaoli;Jiao Baohua(Department of Neurosurgery,the Second Hospitai of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经外科,石家庄050000 [2]河北医科大学第三医院神经外科 [3]石家庄市第三医院神经外科

出　　处：《脑与神经疾病杂志》2022年第5期274-278,共5页Journal of Brain and Nervous Diseases

基　　金：京津冀基础研究合作专项项目(F2019206706);河北省医学重点科技研究计划(20210030);河北医科大学第二医院院基金项目(2HC202010);河北省重点研发计划项目(21377751D)。

摘　　要：目的探究高分辨率光学相干断层扫描(OCT)成像在脑胶质瘤术中定性诊断与边界定位的应用价值。方法选取河北医科大学第二医院脑胶质瘤术中切除的肿瘤组织32例作为研究对象,另选取术中造瘘切除的正常脑组织6例作为对照对象,均行高分辨率OCT成像检查,比较脑胶质瘤组织、正常脑组织(白质、皮质)的衰减系数、前向交叉散射系数,评价两者对脑胶质瘤及其级别的诊断鉴别价值,并分析OCT成像对脑胶质瘤边界定位的价值。结果白质衰减系数、前向交叉散射系数高于脑胶质瘤组织(P<0.05);皮质衰减系数高于脑胶质瘤无坏死区域组织,低于脑胶质瘤有坏死区域组织(P<0.05);皮质前向交叉散射系数低于脑胶质瘤有坏死区域组织(P<0.05);高级别脑胶质瘤组织衰减系数、前向交叉散射系数高于低级别脑胶质瘤组织(P<0.05);ROC曲线分析,衰减系数、前向交叉散射系数诊断脑胶质瘤无坏死区域组织的敏感度、特异度均为100%;以白质为阴性样本,衰减系数、前向交叉散射系数诊断AUC分别为0.782、0.827,最佳截断值分别为7.57、0.270,敏感度分别为92.31%、76.92%,特异度分别为66.67%、83.33%;衰减系数、前向交叉散射系数鉴别脑胶质瘤级别的AUC分别为0.701、0.849,最佳截断值分别为3.86、0.051,敏感度分别为95.83%、83.33%,特异度为37.50%、75.00%;利用OCT成像的光学聚焦原理形成颜色编码图,衰减图、前向交叉散射图均显示,白质和肿瘤边缘具有明显差异,可清晰地观察到分界线;前向交叉散射图显示,皮质与星形细胞瘤类似,边缘相对模糊,但从视觉上可观察到,大脑皮质在跨越灰质-白质边缘产生的颜色编码图被较好地防御住。结论高分辨率OCT成像可作为脑胶质瘤术中定性诊断与边界定位的可靠检查方式,能为手术操作提供有效信息,有利于保障手术治疗效果。Objective To explore the application value of high-resolution optical coherence tomography(OCT)imaging in the qualitative diagnosis and boundary location of glioma during surgery.Methods 32 cases of tumor tissues removed during glioma surgery in the Second Hospital of Hebei Medical University were selected as the research objects,and 6 cases of normal brain tissues removed during the operation of glioma were selected as control objects.All of them underwent high-resolution OCT imaging to compare brain glia.The attenuation coefficient and forward cross-scattering coefficient of tumor tissue and normal brain tissue(white matter,cortex),to evaluate the diagnostic value of the two for glioma and its grade,and to analyze the value of OCT imaging for the boundary location of glioma.Results The white matter attenuation coefficient and forward cross scattering coefficient were higher than those of glioma tissue(P<0.05);the cortical attenuation coefficient was higher than that of glioma tissue without necrosis,and lower than that of glioma tissue with necrosis(P<0.05);the cortical forward cross-scatter coefficient is lower than that of glioma tissues with necrosis(P<0.05);the attenuation coefficient and forward cross-scatter coefficient of high-grade glioma tissue are higher than those of low-grade glioma tissue(P<0.05);ROC curve analysis,the sensitivity and specificity of the attenuation coefficient and forward cross scatter coefficient in diagnosing the nonnecrotic area of glioma are both 100%;with white matter as the negative sample,the attenuation coefficient and forward cross scatter coefficient in the diagnosis of AUC are respectively 0.782,0.827,the best cut-off values were 7.57,0.270,sensitivity were 92.31%,76.92%,specificity were 66.67%,83.33%;attenuation coefficient,forward cross-scatter coefficient to identify the AUC of glioma grade They are 0.701 and 0.849,the best cut-off values are 3.86 and 0.051,respectively,the sensitivity is 95.83%,83.33%,the specificity is 37.50%,75.00%;the optical focusing principle of

关 键 词：脑胶质瘤 高分辨率光学相干断层扫描成像 衰减系数 前向交叉散射系数 定性诊断 边界定位 

分 类 号：R739.4[医药卫生—肿瘤]