ADC值在胶质瘤分级及瘤体微观结构评估中的应用价值  

Application of apparent diffusion coefficient in glioma classification and glioma microstructure evaluation

作　　者：李香营[1] 苏文蕊 王丹风 严承功[3] 梁其洲[1] 聂柳[4] 王世旺 杨光[1] 袁园[1] Li Xiangying;Su Wenrui;Wang Danfeng;Yan Chenggong;Liang Qizhou;Nie Liu;Wang Shiwang;Yang Guang;Yuan Yuan(Department of Radiology,Haikou Hospital Affiliated to Xiangya Medical College of Central South University/Haikou People′s Hospital,Haikou 570208,China;Emergency Department of Donghu District,the Second Affiliated Hospital of Hainan Medical University,Haikou 570203,China;Department of Medical Imaging Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Neurosurgery,Haikou Hospital Affiliated to Xiangya Medical College of Central South University/Haikou People′s Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院/海口市人民医院放射科,海口570208 [2]海南医学院第二附属医院东湖院区急诊科,海口570203 [3]南方医科大学南方医院医学影像中心,广州510515 [4]中南大学湘雅医学院附属海口医院/海口市人民医院神经外科,海口570208

出　　处：《中国医师杂志》2022年第8期1160-1164,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(81360228);海南省卫生计生委项目(18A200128;琼卫2011-67);海南省自然科学基金高层次人才项目(820RC783);海南省自然科学基金项目(813259);海口市重点科技计划项目(2013-72)。

摘　　要：目的探讨磁共振扩散加权成像(DWI)参数表现弥散系数(ADC)值在胶质瘤分级及脑胶质瘤瘤体微观结构评估中的价值。方法回顾性分析2017年6月至2019年11月中南大学湘雅医学院附属海口医院经手术病理证实的胶质瘤患者38例,并依据病理结果分为低级别(WHOⅠ~Ⅱ级,15例)脑胶质瘤组和高级别(WHOⅢ~Ⅳ级,23例)脑胶质瘤组,分别接受MRI平扫和DWI扫描,比较不同级别胶质瘤瘤体区ADC值、微观结构的差异,分析脑胶质瘤瘤体ADC值与血管内皮生长因子(VEGF)阳性细胞百分比、细胞密度、水通道蛋白1(AQP1)表达的累积光密度(IOD)值的相关性。结果(1)MRI检查结果显示,低级别胶质瘤信号多较均匀,无或轻微瘤周水肿及占位效应,增强多不强化或轻度强化,高级别胶质瘤信号因坏死及出血多不均质,瘤周水肿和占位效应较明显,呈不均匀明显强化或不规则环状强化;(2)高级别胶质瘤瘤体VEGF阳性细胞百分比、细胞密度和AQP1表达的IOD值明显高于低级别胶质瘤,ADC值低于低级别胶质瘤(均P<0.05);(3)脑胶质瘤患者瘤体ADC值与其VEGF阳性细胞百分比、细胞密度、AQP1表达的IOD值均呈负相关(r=-0.55、-0.65、-0.63,均P<0.05)。结论胶质瘤瘤体ADC值可以间接反映VEGF的表达、细胞密度和AQP1阳性表达水平,有助于术前胶质瘤分级及评估瘤体微观结构和生物学特性。Objective To explore the application value of apparent diffusion coefficient(ADC)of magnetic resonance diffusion weighted imaging(DWI)parameters in glioma classification and glioma microstructure evaluation.Methods From June 2017 to November 2019,38 patients with glioma confirmed by surgery and pathology in Haikou Hospital Affiliated to Xiangya Medical College of Central South University were retrospectively analyzed.According to the pathological results,they were divided into low-grade(WHOⅠ-Ⅱ,15 cases)glioma group and high-grade(WHOⅢ-Ⅳ,23 cases)glioma group.They received magnetic resonance imaging(MRI)plain scan and DWI scan respectively,and the ADC value and microstructure of different grades of glioma were compared.The correlation between ADC value of glioma and the percentage of vascular endothelial growth factor(VEGF)-positive cells,cell density and integrated optical density(IOD)value of aquaporin 1(AQP1)expression was analyzed.Results(1)MRI examination showed that the signals of low-grade glioma were more uniform,with no or slight peritumoral edema and space occupying effect,and the enhancement was more non enhanced or slightly enhanced.The signals of high-grade glioma were more heterogeneous due to necrosis and bleeding,and the peritumoral edema and space occupying effect were more obvious,showing uneven obvious enhancement or irregular ring enhancement;(2)The percentage of VEGF positive cells,cell density and the IOD value of AQP1 expression in high-grade glioma were significantly higher than that in low-grade glioma,and the ADC value was lower than that in low-grade glioma(all P<0.05);(3)The ADC value of glioma patients was negatively correlated with the percentage of VEGF-positive cells,cell density,and the IOD value of AQP1 expression(r=-0.55,-0.65,-0.63,all P<0.05).Conclusions The ADC value of glioma can indirectly reflect the expression of VEGF,cell density and AQP1 positive expression level,which is helpful for preoperative glioma classification and evaluation of glioma microstructure and b

关 键 词：神经胶质瘤 磁共振扩散加权成像 表观弥散系数 免疫组织化学 

分 类 号：R739.41[医药卫生—肿瘤]