MRI定量参数鉴别丘脑胶质瘤与转移癌及评估胶质瘤级别  

MRI quantitative parameters for differentiating glioma frommetastasis in thalamus and assessing grade of glioma

作　　者：薛克勤 张小锐 张明[1] 赵向乾 王渊[1] XUE Keqin;ZHANG Xiaorui;ZHANG Ming;ZHAO Xiangqian;WANG Yuan(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radiology,986 Hospital of the Air Force,Xi'an 710054,China;Department of Radiology,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]空军第九八六医院影像科,陕西西安710054 [3]空军军医大学西京医院放射科,陕西西安710032

出　　处：《中国医学影像技术》2023年第6期823-828,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察MRI定量参数鉴别丘脑胶质瘤与转移癌及评估胶质瘤级别的价值。方法回顾性分析经病理确诊或随访复查诊断的58例丘脑胶质瘤(高、低级别胶质瘤分别为21例及37例)及21例丘脑转移癌患者,均接受头部常规MR检查,其中20例高级别胶质瘤、28例低级别胶质瘤及5例转移癌接受1 H-MR波谱(MRS)检查。比较高、低级别胶质瘤及转移癌之间水肿指数(EI)、对比增强率(CER)的差异,以及高、低级别胶质瘤间代谢物比值的差异。针对单因素分析结果显示差异有统计学意义的定量参数绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估其鉴别丘脑胶质瘤与转移癌及评估胶质瘤级别的效能。结果丘脑转移癌EI大于高、低级别胶质瘤(P均<0.05);高级别胶质瘤及转移癌CER均大于低级别胶质瘤(P均<0.05)。丘脑高级别胶质瘤实质区胆碱复合物(Cho)/肌酸(Cr)高于低级别胶质瘤(P=0.01)。高、低级别胶质瘤及转移癌之间,其余定量参数差异均无统计学意义(P均>0.05)。EI鉴别丘脑转移癌与胶质瘤的AUC为0.656,CER及肿瘤实质区Cho/Cr鉴别高级别与低级别胶质瘤的AUC分别为0.801及0.775。结论EI有助于鉴别丘脑胶质瘤与转移癌;CER及肿瘤实质区Cho/Cr可用于鉴别丘脑高、低级别胶质瘤。Objective To explore the value of MRI quantitative parameters for differentiating glioma from metastasis in thalamus and assessing grade of glioma.Methods Data of 58 patients with thalamic gliomas(21 high-grade and 37 low-grade gliomas)and 21 with thalamic metastases confirmed pathologically or with following-up were retrospectively analyzed.All patients underwent routine head MR examination,among them 20 with high-grade glioma,28 with low-grade glioma and 5 with metastases underwent 1 H-MR spectroscopy(MRS)examination.The edema index(EI)and contrast enhancement rate(CER)were compared among high-and low-grade glioma and metastases,while the metabolite ratios were compared between high-and low-grade gliomas.Then receiver operating characteristic(ROC)curves of MRI quantitative parameters being significant different among high-and low-grade glioma and metastases were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy for differentiating high-and low-grade glioma from metastases in thalamus.Results EI of thalamic metastases was higher than that of high-and low-grade glioma(both P<0.05).CER of high-grade glioma and metastases were both higher than that of low-grade glioma(both P<0.05).Choline(Cho)/creatine(Cr)in parenchyma of high-grade glioma was higher than that of low-grade glioma(P=0.01).No significant difference of the other quantitative parameters was found among high-,low-grade gliomas and metastases(all P>0.05).AUC of EI for distinguishing thalamic metastases and glioma was 0.656,of CER and Cho/Cr of parenchyma for distinguishing high-grade and low-grade glioma was 0.801 and 0.775,respectively.Conclusion EI was helpful for differentiating thalamic glioma from metastasis.CER and Cho/Cr of parenchyma could be used for differentiating high-and low-grade gliomas in thalamus.

关 键 词：脑肿瘤 丘脑 磁共振成像 诊断 鉴别 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]