全肿瘤弥散峰度成像直方图分析预测脑膜瘤分级及细胞增殖活性  

Whole-tumor histogram analysis of diffusion kurtosis imaging for predicting grade and proliferation activity of meningioma

作　　者：陈晓丹[1] 郑德春[1] 陈兴发[1] 林孔起 何庄贞 苏丽清 陈韵彬[1] 林霖[2] 薛蕴菁[2] CHEN Xiaodan;ZHENG Dechun;CHEN Xingfa;LIN Kongqi;HE Zhuangzhen;SU Liqing;CHEN Yunbin;LIN Lin;XUE Yunjing(Department of Radiology,Fujian Medical University Cancer Hospital,Fujian Cancer Hospital,Fuzhou 350014,China;Department of Radiology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属肿瘤医院福建省肿瘤医院放射诊断科,福建福州350014 [2]福建医科大学附属协和医院放射科,福建福州350001

出　　处：《中国医学影像技术》2022年第8期1139-1144,共6页Chinese Journal of Medical Imaging Technology

基　　金：福建省科技创新联合资金项目(2018Y9044);福建省卫生健康中青年骨干人才培养项目(2020GGA039);福建省肿瘤放射与免疫治疗临床医学研究中心(2020Y2012)。

摘　　要：目的观察全肿瘤弥散峰度成像(DKI)直方图分析评估脑膜瘤分级及细胞增殖活性的价值。方法根据手术病理结果将174例术前均接受MR DKI检查的脑膜瘤患者分为低级别脑膜瘤(LGM,Ⅰ级)组和高级别脑膜瘤(HGM,Ⅱ/Ⅲ级)组,比较组间平均峰度(MK)、轴向峰度(AK)、径向峰度(RK)、各向异性分数(FA)、平均扩散率(MD)的直方图参数,评估各参数对脑膜瘤分级的诊断效能及其与Ki-67标记指数(LI)间的相关性。结果HGM组MK[第10、50、90百分位数(p10、p50、p90)及均值、最大值、方差]、AK(p10、p50、p90、均值、最大值)、RK(p50、p90、均值、最大值、方差)、MD(方差)及FA(最大值)均高于LGM组(P均<0.05),MD(p10、最小值)低于LGM组(P均<0.05)。上述各参数均可用于鉴别HGM与LGM,尤以MKp90的曲线下面积最大(0.87),准确度为83.33%。Ki-67LI与上述各直方图参数均相关(P均<0.05),与MKp90的相关系数最大(r_(s)=0.64)。结论全肿瘤DKI直方图分析可用于评估脑膜瘤分级及细胞增殖活性。Objective To explore the value of whole-tumor histogram analysis of diffusion kurtosis imaging(DKI)for evaluating the grade and proliferation activity of meningioma.Methods Totally 174 meningioma patients who underwent MR DKI examination before operation were divided into low grade meningioma group(LGM,gradeⅠ)and high grade meningioma group(HGM,gradeⅡ/Ⅲ)according to surgical pathological results.Histogram parameters,including the mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),fractional anisotropy(FA)and the mean diffusivity(MD)were compared between groups,and the diagnostic efficacy was evaluated.The correlations between each histogram parameter and Ki-67 labeling index(LI)were evaluated.Results MK(10 th,50 th,90 th percentiles,and the mean and the maximum,variance),AK(10 th,50 th,90 th percentiles and the mean and the maximum),RK(50 th,90 th percentiles,and the mean and the maximum,variance),MD(variance),FA(the maximum)in HGM group were higher than those in LGM group(all P<0.05),while MD(the 10 th percentile and the minimum)in HGM group were smaller than those in LGM group(both P<0.05).All the above parameters could be used to distinguish HGM from LGM,among which MK 90 th percentile had the largest area under the curve(0.87),with an accuracy of 83.33%.Ki-67 LI was correlated with all the above histogram parameters(all P<0.05),and the correlation coefficient with the 90 th percentile MK was the largest(r_(s)=0.64).Conclusion Whole-tumor DKI histogram analysis could be used to evaluate the grade and proliferation activity of meningioma.

关 键 词：脑膜瘤 弥散磁共振成像 直方图分析 肿瘤分级 细胞增殖 

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