磁共振酰胺质子转移成像在预测脑膜瘤硬度中的可行性研究  

Feasibility study of amide proton transfer weighted magnetic resonance imaging in predicting meningioma stiffness

作　　者：于昊 王显龙[2] 孙占国[1] 温志波[2] 崔昌萌 陈月芹[1] Yu Hao;Wang Xianlong;Sun Zhanguo;Wen Zhibo;Cui Changmeng;Chen Yueqin(Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Radiology,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;Department of Neurosurgery,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院医学影像科,济宁272029 [2]南方医科大学珠江医院放射科,广州510282 [3]济宁医学院附属医院神经外科,济宁272029

出　　处：《中华神经外科杂志》2022年第8期831-836,共6页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金(82001805)。

摘　　要：目的:探讨磁共振酰胺质子转移(APTw)成像在评估脑膜瘤硬度中的可行性。方法:回顾性分析2017年1月至2020年7月济宁医学院附属医院神经外科收治的48例脑膜瘤患者的临床资料。所有患者均于术中评估肿瘤的硬度,并分为质软(6例)、中等硬度(21例)、质硬(21例)3个等级。分析48例脑膜瘤患者的常规头颅MRI及APTw-MRI图像,测量瘤核心的APTw min、APTw mean、APTw max值(分别为5个感兴趣区的APTw信号强度最小值、平均值和最大值)。比较质软、中等硬度、质硬3组患者的年龄、性别、水肿指数、T1加权成像(T1WI)和T2加权成像(T2WI)信号特点,以及APTw min、APTw mean、APTw max值之间的差异。采用两独立样本t检验分别比较质硬组和非质硬组(包括肿瘤质软和中等硬度患者)APTw min、APTw mean和APTw max值的差异。运用受试者工作特征曲线评价APTw各参数在区分脑膜瘤不同硬度方面的诊断效能。结果:3组不同硬度脑膜瘤患者的年龄、性别、水肿指数、病变T1WI和T2WI信号特点以及APTw max值的差异均无统计学意义(均P>0.05)。3组肿瘤病理学类型间的差异具有统计学意义(P=0.030)。质硬组的APTw min和APTw mean值小于中等硬度组和质软组(均P<0.001),但中等硬度组与质软组的差异均无统计学意义(均P>0.05)。质硬组的APTw min值[(1.94±0.70)%对比(2.86±0.45)%]和APTw mean值[(2.47±0.83)%对比(3.29±0.35)%]小于非质硬组(均P<0.001)。APTw min为评估脑膜瘤硬度的最佳指标,当APTw min值<2.47%时,提示脑膜瘤质硬的灵敏度为88.9%,特异度为85.7%,准确度为85.4%。结论:初步研究表明,APTw-MRI技术可用于预测脑膜瘤的硬度,其中APTw min的预测效能最佳。Objective To investigate the feasibility of amide proton transfer weighted(APTw)magnetic resonance imaging(MRI)in the assessment of meningioma stiffness.Methods The clinical data of 48 patients with meningioma admitted to the Department of Neurosurgery,Affiliated Hospital of Jining Medical University from January 2017 to July 2020 were retrospectively analyzed.All patients were evaluated for tumor stiffness during operation,and were divided into three grades:soft(6 cases),medium stiffness(21 cases),and hard(21 cases).The conventional head MRI and APTw-MRI images of 48 patients with meningioma were analyzed,and the APTwmin,APTwmean,and APTwmax values in the tumor core were measured(the minimum,average,and maximum APTw signal intensities of the five regions of interest,respectively).The gender,age,edema index,T1-weighted imaging(T1WI)and T2-weighted imaging(T2WI)signal intensities,as well as APTwmin,APTwmean,and APTwmax values of the three groups were compared.The differences in APTwmin,APTwmean and APTwmax values were compared between the hard and non-hard groups(including patients with soft and moderate stiffness)by using two indepedent samples T-test.The receiver operating characteristic(ROC)and area under the curve(AUC)were used to evaluate the diagnostic performance of APTw parameters in differentiating meningiomas with different stiffness.Results There were no significant differences in age,gender,edema index,T1WI,T2WI signal characteristics or APTwmax value among the three groups of meningiomas with varying stiffness(all P>0.05).The difference between the three groups of tumor pathological types was statistically significant(P=0.030).The APTwmin and APTwmean values of the hard group were lower than those of the medium-stiffness group and the soft group(both P<0.001),but there was no significant difference between the medium-stiffness group and the soft group(both P>0.05).The APTwmin value[(1.94±0.70)%vs.(2.86±0.45)%]and APTwmean value[(2.47±0.83)%vs.(3.29±0.35)%]in the hard group were lower than those in

关 键 词：脑膜瘤 磁共振成像 硬度 酰胺质子转移 预测效能 

分 类 号：R739.45[医药卫生—肿瘤]