磁共振弥散白质定量分析在观察脑低级别胶质瘤相关性癫痫白质变化中的应用  

Application of quantitative magnetic resonance diffusion white matter analysis in the observation of white matter changes in low-grade glioma-associated epilepsy

作　　者：高安康 高而远 齐金博 赵锴 赵高炀 陈婷 张会婷 严序 赵国桦 马潇越 白洁[1] 张勇[1] 程敬亮[1] GAO Ankang;GAO Eryuan;QI Jinbo;ZHAO Kai;ZHAO Gaoyang;CHEN Ting;ZHANG Huiting;YAN Xu;ZHAO Guohua;MA Xiaoyue;BAI Jie;ZHANG Yong;CHENG Jingliang(Department of MR,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of MR Scientific Marketing,Siemens Healthineers,Shanghai 201318,China)

机构地区：[1]郑州大学第一附属医院磁共振科,郑州450052 [2]西门子医疗系统有限公司磁共振科研市场部,上海201318

出　　处：《磁共振成像》2023年第8期10-18,共9页Chinese Journal of Magnetic Resonance Imaging

基　　金：河南省科技攻关计划联合共建项目(编号:LHGJ20220403)。

摘　　要：目的 采用磁共振弥散白质定量技术观察低级别脑胶质瘤瘤体和瘤周白质变化在胶质瘤相关癫痫(glioma-associated epilepsy, GAE)发生中的影响。材料与方法 回顾性分析了2018年12月至2020年12月在郑州大学第一附属医院磁共振科进行弥散频谱成像(diffusion spectrum imaging, DSI)扫描且经病理证实为低级别胶质瘤患者的临床和影像学信息,共纳入102例WHOⅡ级低级别胶质瘤,其中术前GAE患者37名,术前无GAE患者65名。计算弥散张量成像(diffusion-tensor imaging, DTI)、轴突定向弥散和密度成像(neurite orientation dispersion and density imaging, NODDI)及平均表观传播子(mean apparent propagator, MAP)等弥散模型的定量参数。应用ITK-SNAP软件在b=0的弥散图像上进行肿瘤及瘤周区的感兴趣区(region of interest, ROI)勾画。应用FAE软件进行直方图特征提取、ROI体积计算和形态学特征提取。经单参数分析及共线分析后基于各弥散模型及ROI构建逻辑回归模型,并应用DeLong检验进行模型效能的比较。结果 GAE组间年龄差异有统计学意义(P=0.004);肿瘤位于右侧半球且跨半球生长者GAE的发病率低于位于左侧半球者,差异有统计学意义(P=0.002);年龄和肿瘤所在半球位置所构建GAE预测临床影像学模型AUC=0.779。GAE组肿瘤和瘤周的体积小于无GAE组(P<0.05);肿瘤区诸形态学特征差异无统计学意义;瘤周区长径、短径越小越倾向于GAE发生,同时表面积越小、越倾向于球形者倾向于GAE发生,差异有统计学意义(P<0.05);应用瘤周区形态学特征构建GAE logistic回归模型的AUC=0.730。存在GAE组间差异(P<0.05)的肿瘤区和瘤周区弥散模型定量参数直方图特征包括DTI_FA_Maximum、 NODDI_ODI_90 Percentile、MAP_NG_10 Percentile,其中瘤周区NODDI_ODI_90Percentile值GAE组高于无GAE组,余瘤周区同肿瘤区特征GAE组均低于无GAE组。肿瘤区模型效能略高于瘤周区模型,差异无统计学意义;肿瘤Objective:To observe the effect of low-grade glioma(LGG)tumor and peritumoral white matter changes in the occurrence of glioma-associated epilepsy(GAE)by magnetic resonance diffusion white matter quantification analysis.Materials and Methods:The clinical and imaging information of patients with LGG confirmed by pathology who underwent diffusion spectrum imaging(DSI)in the First Affiliated Hospital of Zhengzhou University from December 2018 to December 2020 was retrospectively analyzed.A total of 102 patients with WHOⅡlow-grade gliomas were enrolled,including 37 patients with preoperative GAE and 65 patients without preoperative GAE.Diffusion tensor imaging(DTI),neurite orientation dispersion and density imaging(NODDI)and mean apparent propagator(MAP)metrics.ITK snap was used to draw tumor and peritumoral regions of interest(ROI)were based on b=0 diffusion images.FAE was used to perform histogram feature extraction,volume calculation of interest,and morphological feature extraction.After single parameter analysis and collinear analysis,logistic regression models were constructed based on each diffusion model and ROIs,and the DeLong test was used to compare the performance of models.Results:There is a statistical difference in age between GAE groups(P=0.004).The incidence of GAE in patients with tumors located in the right hemisphere and trans hemisphere growth was lower than that in patients with tumors located in the left hemisphere,with a statistically significant difference(P=0.002).GAE predictive clinical-imaging model is constructed by age and hemispheric location of tumor,with AUC=0.779.The tumor and peritumoral volumes in the GAE group were significantly smaller than those in the non-GAE group(P<0.05).There was no statistical difference in the morphological characteristics of the tumor area.The smaller the long and short diameters of the peritumoral area,the smaller the surface area,the more likely it is to be spherical,with higher incidence of GAE,and the difference is statistically significant(P<0.05);t

关 键 词：低级别胶质瘤 磁共振弥散成像 磁共振成像 脑白质 胶质瘤相关癫痫 直方图 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.264[医药卫生—诊断学]