合成扩散加权成像评估脑胶质瘤分级的应用研究  

Application of synthetic diffusion-weighted imaging in evaluating the grading of glioma

作　　者：吕瑞瑞 党佩 葛鑫 李敏 黄雪莹[2] 王明磊[2] 杨旭宏 雍鹏 王晓东[2] LÜRuirui;DANG Pei;GE Xin;LI Min;HUANG Xueying;WANG Minglei;YANG Xuhong;YONG Peng;WANG Xiaodong(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;GE Healthcare,MR Enhancement Application,Beijing 100176,China)

机构地区：[1]宁夏医科大学临床医学院,银川750004 [2]宁夏医科大学总医院放射科,银川750004 [3]通用电气医疗(中国)磁共振部,北京100176

出　　处：《磁共振成像》2022年第7期12-16,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区自然科学基金(编号:2022AAC03487);宁夏回族自治区科技重点研究计划(编号:2019BEG03037)。

摘　　要：目的探讨合成扩散加权成像(synthetic DWI,sDWI)在高低级别胶质瘤评估中的应用价值。材料与方法回顾性分析术前一周行颅脑MRI(GE Signa Architect 3.0 T)检查的脑胶质瘤患者,根据纳入排除标准纳入72例患者病例(低级别胶质瘤30例,高级别胶质瘤42例),两名神经影像诊断医师采用双盲法在sDWI上对图像进行评估勾画病灶感兴趣区,对不同b值对应DWI图像信号强度进行分析并与最终病理结果进行对照。两组间比较使用独立样本t检验,使用logistic回归和受试者工作特征曲线下面积(area under the curve,AUC)分析评估高低级别胶质瘤诊断效能。结果在鉴别高低级别胶质瘤方面,sDWI b值为500、800、1000、1200、1500、1800、2000、2200、2500 s/mm^(2)对应的信号强度值,差异均有统计学意义(P<0.001),b值为2500 s/mm^(2)时鉴别高低级别胶质瘤的诊断效能最高,AUC为0.935,敏感度为98%,特异度为87%。结论sDWI单次扫描可获得0~2500 s/mm^(2)任意b值对应的信号强度值,b值越高对胶质瘤分级的诊断效能越高。Objective:To evaluate the value of synthetic diffusion-weighted imaging(synthetic DWI)in the evaluation of high and low grade gliomas.Materials and Methods:The patients with gliomas were analyzed retrospectively,who underwent brain MRI(GE Signa Architect 3.0 T)one week before operation.Finally,72 patients were included according to the inclusion and exclusion criteria(30 low-grade gliomas and 42 high-grade gliomas).Two neuroimaging diagnostic physicians used the double-blind method to evaluate and outline the region of interest(ROI)of the lesions on synthetic DWI.The signal intensity of DWI images with different b values was analyzed and compared with the final pathological results.Independent sample t test was used to compare between the two groups.Logistic regression and area under the receiver operating characteristic curve(AUC)analysis were used to evaluate the diagnostic efficacy of high and low grade gliomas.Results:For differentiating high and low grade gliomas,the synthetic DWI b values were 500,800,1000,1200,1500,1800,2000,2200 and the signal intensity values corresponding to 2500 s/mm2 were statistically significant(P<0.001).When b value was 2500 s/mm2,the diagnostic efficiency of differentiating high and low grade gliomas was the highest,AUC was 0.935,the sensitivity was 98%,and the specificity was 87%.Conclusions:A single scan of synthetic DWI can obtain the corresponding signal intensity value under any b values from 0 to 2500 s/mm2,and with the increasing of b values,the diagnostic efficiency of glioma grading is higher.

关 键 词：胶质瘤 磁共振成像 合成扩散加权成像 分级 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.264[医药卫生—诊断学]