基于IVIM与DSC-MRI无创预测低级别胶质瘤IDH突变状态和Ki-67表达情况  

Noninvasive prediction of IDH mutation status and Ki-67 expression in low-grade gliomas based on IVIM and DSC-MRI

作　　者：卢俊 李祥 黎海亮 LU Jun;LI Xiang;LI Hailiang(Departmentof Radiology,the Affiliated Cancer Hospitalof Zhengzhou University,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院放射科,河南郑州450008

出　　处：《实用放射学杂志》2022年第5期707-711,共5页Journal of Practical Radiology

摘　　要：目的探讨体素内不相干运动(IVIM)和动态磁敏感对比增强磁共振成像(DSC-MRI)能否无创预测低级别胶质瘤(LGG)异柠檬酸脱氢酶(IDH)突变状态和Ki-67标记指数(Ki-67 LI)。方法选取经病理证实的LGG患者64例,IDH突变状态和Ki-67表达情况均已知。术前行IVIM和DSC-MRI检查。测量假性扩散系数(D^(*))、真性扩散系数(D)、灌注分数(f)、脑血容量(CBV)和脑血流量(CBF)。Spearman秩相关用于参数间相关性分析。组间参数比较用独立样本t检验。受试者工作特征(ROC)曲线用于评估预测效能。建立单变量和多变量逻辑回归预测模型。结果IVIM和DSC-MRI参数呈低到中等程度相关性。除CBF外其余参数在IDH突变和野生组间有显著差异(P<0.05)。D^(*)、D、f和CBV在Ki-67高、低表达组间有显著差异(P<0.05),CBF在2组间无差异(P>0.05)。经多变量逻辑回归分析,多变量模型在预测IDH突变状态和Ki-67 LI时诊断效能最高,曲线下面积(AUC)分别为0.907(0.808~0.965)、0.931(0.839~0.979)。结论IVIM和DSC-MRI能有效预测LGG IDH突变状态和Ki-67表达情况,2种成像方式结合能提高预测效能。D^(*)值是IDH突变状态和Ki-67表达情况预测价值较好的影像学指标。Objective To investigate whether intravoxel incoherent motion(IVIM)and dynamic susceptibility contrast magnetic resonance imaging(DSC-MRI)could assess the isocitrate dehydrogenase(IDH)mutation status and Ki-67 labeling index(Ki-67 LI)of low-grade gliomas(LGG)noninvasively.Methods Sixty-four LGG patients confirmed by pathology with known IDH mutation status and Ki-67 expression were selected.All patients underwent IVIM and DSC-MRI examination before operation.The D^(*),D,f,cerebral blood volume(CBV)and cerebral blood flow(CBF)were measured.Correlation among parameters was analyzed by the Spearman rank correlation.All parameters between different groups were compared with independent t test.The receiver operating characteristic(ROC)curve was performed to assess the predicting efficacy.Univariate and multivariate Logistic regression prediction models were constructed.Results The IVIM and DSC-MRI parameters showed low to moderate correlations.All parameters except CBF showed significant differences between IDH mutatnt group and IDH wild group(P<C0.05).D^(*),D,f and CBV showed significant differences between Ki-67 high expression and low expression(P<0.05),CBF showed no significant difference between two groups(P>0.05).With multivariate Logistic regression,multivariate model had the highest diagnostic efficacy for assessing IDH mutation status and Ki-67 LI with area under the curve(AUC)of 0.907(0.808-0.965)and 0.931(0.839-0.979).Conclusion IVIM and DSC-MRI can effectively predict the IDH mutation status and Ki-67 expression in LGG,and the combination of two ways can improve the predicting efficacy.The D^(*)value is a imaging marker with good predictive value for predicting IDH mutation status and Ki-67 expression.

关 键 词：体素内不相干运动 动态磁敏感对比增强磁共振成像 低级别胶质瘤 异柠檬酸脱氢酶 KI-67标记指数 

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] R446.8[医药卫生—临床医学]