Synthetic MRI联合DSC成像在胶质瘤分级及肿瘤细胞增殖活性预测中的临床价值  

The clinical value of synthetic MRI combined with DSC imaging in grading gliomas and prediction of tumor cell proliferative

作　　者：葛鑫 申颖 孙胜玉[3] 王爱军[4] 刘文潇 吴静 王晓东[4] GE Xin;SHEN Ying;SUN Shengyu;WANG Aijun;LIU Wenxiao;WU Jing;WANG Xiaodong(Clinical Medical College of Ningxia Medical University,Yinchuan 750004;School of Nursing,Ningxia Medical University,Yinchuan 750004,China;Departmentof Neurosurgery,the General Hospitalof Ningxia Medical University,Yinchuan 750004,China;Departmentof Radiology,the General Hospitalof Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学护理学院,宁夏银川750004 [3]宁夏医科大学总医院神经外科,宁夏银川750004 [4]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《实用放射学杂志》2022年第5期702-706,共5页Journal of Practical Radiology

基　　金：宁夏回族自治区自然科学基金项目(2022AAC03487).

摘　　要：目的探讨合成磁共振成像(sy-MRI)联合动态磁敏感对比增强(DSC)成像在胶质瘤分级及细胞增殖活性预测中的临床价值。方法回顾性分析60例胶质瘤患者,其中低级别(LGG)22例,高级别(HGG)38例。所有患者术前行sy-MRI和DSC序列扫描,术后标本行Ki-67免疫组化染色。由2名放射科医师在T_(1)map、T_(2)map、相对脑血流量(rCBF)和相对脑血容量(rCBV)伪彩图上,选取肿瘤实质最大层面画取感兴趣区(ROI),并测量增强前T_(1)值(native-T_(1))、增强前T_(2)值(native-T_(2))、增强后T_(1)值(enhanced-T_(1))、增强前后T1值变化的百分比(T_(1))、rCBF和rCBV。利用独立样本t检验或Mann-Whitney U检验比较2组间各参数的差异,利用Spearman’s法分析各参数与Ki-67标记指数(Ki-67 LI)之间的相关性,采用受试者工作特征(ROC)曲线评估其在分级中的诊断效能。结果HGG组T_(1)、rCBF和rCBV均高于LGG组(P<0.01),HGG组enhanced-T_(1)低于LGG组(P<0.01),T_(1)、rCBF、rCBV与Ki-67 LI均呈正相关(r值分别为0.643、0.324、0.411,P<0.05),enhanced-T_(1)与Ki-67 LI呈负相关(r=-0.619,P<0.01)。Enhanced-T_(1)、T_(1)、rCBF和rCBV鉴别HGG、LGG的曲线下面积(AUC)分别为0.972、0.990、0.775和0.849。结论sy-MRI能够反映组织微观结构信息,是胶质瘤分级诊断和预测肿瘤增殖活性的成像新技术,其中T_(1)的诊断效能最高。DSC可用于胶质瘤微血管灌注的评估,是评估分级的重要补充。Objective To explore the clinical value of synthetic magnetic resonance imaging(sy-MRI)combined with dynamic susceptibility contrast(DSC)imaginginthe grading of gliomas andthe prediction of cell proliferative activity.Methods 60 patients with gliomas were analyzed retrospectively,including22 cases of low-grade glioma(LGG)and38 cases of high-grade glioma(HGG).All patients underwent sy-MRI and DSC scans preoperatively,and the specimen after operation underwent Ki-67 immunohistochemical staining.Onthe pseudo-color maps of T_(1)map,T_(2)map,relative cerebral blood flow(rCBF)and relative cerebral blood volume(rCBV),two radiologists selected the maximum slicer of the tumor parenchyma to draw region of interest(ROI)and measuredpre-enhanced T_(1)value(native-T_(1)),pre-enhanced T_(2)value(native-T_(2)),post-enhanced T_(1)(enhanced-T_(1)),percentage of T_(1)change before and after enhancement(ΔT_(1)),rCBF andr CBVI.ndependent sample t-test or Mann-Whitney U-test was used to compare the differences of parameters between two groups.Spearman’s was used to analyze the correlation between parameters and Ki-67 labeling index(Ki-67 LI).The receiver operatingcharacteristic(ROC)curves were usedto assessthe diagnostic efficacy of parameters in the grading assessment of gliomas.ResultsΔT_(1),rCBF and rCBV were significantly higherin HGG group than LGG group(P<0.01),and enhanced-T_(1)was signifi-cantly lower in HGG group than LGG group(P<0.01).ΔT_(1),rCBF and rCBV were positively correlated with Ki-67 LI(r=0.643,0.324,0.411,respectively,all P<0.05),while enhanced-T_(1)was negatively correlated with Ki-67 LI(r=-0.619,P<0.01).The area under the curve(AUC)of the enhanced-T_(1),ΔT_(1),rCBFand rCBV for distinguishing HGG and LGG were 0.972,0.990,0.775,0.849,respectively.Conclusion sy-MRI,which can reflect tissue microstructure information,is a newimaging techniquefor grading diagnosis and predicting tumor proliferativea ctivity of gliomas.ΔT_(1)has the highest diagnostic efficiency.The DSC can be used to evaluate the microvascular

关 键 词：胶质瘤 分级 细胞增殖 合成磁共振成像 动态磁敏感对比增强 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]