ADC值改善少突胶质细胞肿瘤分级诊断效能的初步研究  

ADC value in improving the diagnostic performance of oligodendroglial tumor grading:a preliminary study

作　　者：杨海婷[1] 蒋健[1] 周俊林[1] YANG Hai-ting;JIANG Jian;ZHOU Jun-lin(Department of Radiology,Lanzhou University Second Hospital,Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院放射科医学影像人工智能甘肃省国际科技合作基地,甘肃兰州730030

出　　处：《中国临床医学影像杂志》2022年第10期685-690,共6页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金面上项目(81772006,82071872);甘肃省科技计划项目(21YF5FA123);甘肃省自然科学基金项目(21JR11RA105);兰州大学第二医院“萃英科技创新计划”应用基础研究项目(CY2017-MS03,CY2021-MS-B06);兰州大学第二医院萃英研究生指导教师培育计划(CYDSPY202006)。

摘　　要：目的:探讨常规MRI征象结合ADC值在少突胶质细胞肿瘤分级诊断中的价值。方法:回顾性分析经病理证实的65例少突胶质细胞肿瘤患者的临床、MRI及病理资料,其中少突胶质细胞瘤(OD)30例(WHO 2级),间变性少突胶质细胞瘤(AOD)35例(WHO 3级)。比较两组患者主要临床指标(性别、年龄)、常规MRI征象(肿瘤部位、瘤周界面、跨越中线、坏死囊变、出血、瘤周水肿、强化程度)和表观扩散系数(ADC)值(最小ADC值(ADC_(min))、平均ADC值(ADC_(mean))、相对ADC值(rADC))间差异。对有统计学意义的参数,使用二元Logistic回归分析分别构建临床-常规MRI征象模型和临床-常规MRI征象-ADC_(min)模型。绘制受试者工作特征曲线(ROC)评估各参数对少突胶质细胞肿瘤分级诊断的效能。结果:OD组平均发病年龄明显小于AOD组,组间差异存在统计学意义(P=0.028);而两组性别间差异无统计学意义(P=0.399)。OD组和AOD组在瘤周界面、坏死囊变、瘤周水肿程度、强化程度间差异均具有统计学意义(P<0.05),AOD患者更容易出现瘤周界面不清晰、坏死囊变、中/重度瘤周水肿和中度以上强化;而两组肿瘤部位、跨越中线、出血间差异均无统计学意义(P>0.05)。OD组ADC_(min)、ADC_(mean)和rADC均大于AOD组,组间差异均具有统计学意义(P<0.05)。ROC分析结果显示临床-常规MRI征象-ADC_(min)模型的分级诊断效能最佳,分级的AUC、敏感度、特异度、阳性预测值、阴性预测值和准确度分别为0.907、88.57%、86.67%、88.60%、86.70%和87.69%。结论:常规MRI征象结合ADC值可有效用于少突胶质细胞肿瘤的分级诊断,为临床诊疗提供参考。Objective:To investigate the value of conventional MRI signs combined with apparent diffusion coefficient(ADC)values in the grading diagnosis of oligodendroglial tumor.Methods:The clinical,MRI and pathological data of 65 patients with oligodendroglial tumor confirmed by pathology were retrospectively analyzed,including 30 cases of oligodendroglioma(OD)(WHO grade 2)and 35 cases of anaplastic oligodendroglioma(AOD)(WHO grade 3).The differences between the main clinical indicators(age,gender),conventional MRI signs(location,tumor boundary,crossing midline,cystic degeneration and necrosis,hemorrhage,peritumor edema,degree of enhancement),and ADC values(minimum ADC value(ADC_(min)),mean ADC value(ADC_(mean)),relative ADC value(rADC))were compared between the two groups.Clinical-conventional MRI sign model and clinical-conventional MRI sign-ADC_(min) model were established using binary Logistic regression analysis based on statistically significant parameters.Receiver operating characteristic(ROC)curves were drawn to analyze the grading diagnostic efficacy of each parameter for oligodendroglial tumor.Results:The mean age of onset of OD group was significantly less than that of AOD group,with a significant difference between the two groups(P=0.028),and no gender difference between the two groups(P=0.399).The differences between OD group and AOD group in the tumor boundary,cystic degeneration and necrosis,peritumor edema,degree of enhancement were statistically significant(all P<0.05).The AOD patients are more likely to have unclear tumor boundary,necrotic cystic changes,moderate/severe peritumoral edema,and moderate or greater enhancement,while the location,crossing midline,and hemorrhage between the two groups were not statistically significant(all P>0.05).ADC_(min),ADC_(mean) and rADC in the OD group were greater than those in the AOD group,and the differences were statistically significant(P<0.05).ROC analysis showed that the clinical-conventional MRI sign-ADC_(min) model had the best grading diagnostic efficacy,with

关 键 词：少突神经胶质瘤 磁共振成像 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]