体素内不相干运动评估胶质瘤分级及其与Ki-67指数相关性研究  

Evaluation of glioma grade by IVIM and its correlation with Ki-67 index

作　　者：朱敏[1] 邓克学 邱俊 刘钰婵 ZHU Min;DENG Kexue;QIU Jun(Imaging Center,Southern District of the First Affiliated Hospital of USTC,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)南区影像中心,合肥230036

出　　处：《临床外科杂志》2022年第10期925-929,共5页Journal of Clinical Surgery

摘　　要：目的探讨胶质瘤瘤体区及瘤周水肿区体素内不相干运动(intravoxel incoherent motion,IVIM)参数评估肿瘤分级的价值,及其与Ki-67标记指数表达的相关性。方法2019年4月~2020年12月我院收治的脑胶质瘤病人51例,术前均行颅脑MRI平扫及增强、IVIM检查,术后经免疫组化获得胶质瘤Ki-67标记指数。分别测量肿瘤最大层面实性区域、瘤周水肿区域的IVIM参数,获得ADC、纯水扩散系数(pure water diffusion coefficient,D)、假扩散系数(pseudo-diffusion coefficient,D*)、灌注分数(perfusion fraction,f)值,使用Kruskal-Wallis检验及Mann-Whitney U检验比较Ⅱ、Ⅲ、Ⅳ级间及高、低级别组间瘤体区及瘤周水肿区4个定量参数差异。应用ROC曲线评估各参数在胶质瘤高低级别鉴别中的诊断效能。利用Spearman法分析IVIM定量参数与Ki-67标记指数之间的相关性。结果Ⅱ级ADC值高于Ⅲ级、Ⅳ级,低级别胶质瘤高于高级别;Ⅱ级D值高于Ⅳ级,低级别胶质瘤高于高级别;Ⅱ级、Ⅲ级D*值低于Ⅳ级。Ⅱ级f值低于Ⅳ级。瘤周水肿区域,Ⅲ级ADC值高于Ⅳ级;Ⅱ级胶质瘤D值高于Ⅲ级,Ⅲ级胶质瘤D值低于Ⅳ级;D*值各级别间未见明显差异;Ⅱ级胶质瘤f值低于Ⅳ级;Ⅱ级f值低于Ⅳ级。水肿区诸参数在低、高级别胶质瘤间差异无明显统计学意义。Ki-67指数与瘤体区ADC、D值呈负相关,与D*呈正相关。Ki-67与瘤周水肿参数之间无显著相关性。结论胶质瘤瘤体区IVIM参数可无创评估肿瘤分级,并与Ki-67指数相关。Objective To evaluate the value of intravoxel incoherent motion(IVIM) parameters in a group of patients with pre-operative gliomas, predicting tumor grade in the solid tumor area and peritumoral edema areas, and its correlation with the expression of Ki-67.Methods A retrospective analysis of 51 patients with histopathologically confirmed gliomas was performed.All patients underwent brain MRI scan, enhanced and IVIM examination before operation, and the Ki-67 marker index of glioma was obtained by immunohistochemistry after operation.The IVIM parameters of the largest solid area of the tumor and the peritumoral edema area were measured respectively to obtain ADC,pure water diffusion coefficient(D),pseudo-diffusion coefficient(D*),and perfusion fraction(perfusion).fraction, f) value, Kruskal-Wallis test and Mann-Whitney U test were used to compare the differences of four quantitative parameters of tumor body area and peritumoral edema area between grades Ⅱ,Ⅲ,and Ⅳ and between high and low grade groups.The ROC curve was used to evaluate the diagnostic performance of each parameter in differentiating high and low grades of glioma.Spearman’s method was used to analyze the correlation between IVIM quantitative parameters and Ki-67 labeling index.Results The ADC value of grade Ⅱ was higher than that of grade Ⅲ and Ⅳ,and that of low-grade glioma was higher than that of high-grade glioma;The D value of grade Ⅱ was higher than that of grade Ⅳ,and the low-grade glioma was higher than that of high-grade glioma;The D*value of grade Ⅱ and Ⅲ is lower than grade Ⅳ.The f value of grade Ⅱ is lower than grade Ⅳ.In the peritumoral edema area, the ADC value of grade Ⅲ is higher than that of grade Ⅳ;The D value of grade Ⅱ glioma is higher than grade Ⅲ,and the D value of grade III glioma is lower than grade Ⅳ;There is no significant difference between the levels of D*value;The f value of grade Ⅱ glioma was lower than grade Ⅳ;Level Ⅱ f value is lower than level Ⅳ.There was no significant dif

关 键 词：磁共振成像 体素内不相干运动成像 胶质瘤 KI-67标记指数 瘤周水肿 

分 类 号：R739.41[医药卫生—肿瘤]