扩散加权成像多模型参数在脑胶质瘤术前分级诊断中的应用研究  

Application of multi-model diffusion weighted imaging in preoperative grading diagnosis of glioma

作　　者：李伟栋 许倩 张晓丹[2] 张超 徐凯 胡春峰 LI Weidong;XU Qian;ZHANG Xiaodan;ZHANG Chao;XU Kai;HU Chunfeng(Department of Medical Imaging,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Medical Imaging,Huai′an First People′s Hospital,Huai′an,Jiangsu 223300)

机构地区：[1]徐州医科大学附属医院影像科,江苏徐州221000 [2]淮安市第一人民医院影像科,江苏淮安223300

出　　处：《徐州医科大学学报》2023年第12期916-921,共6页Journal of Xuzhou Medical University

基　　金：江苏省老年健康科研项目(LKM2023014);徐州市卫生健康委员会青年医学科技创新项目(XWKYHT20210586);徐州医科大学校级课题(2012KJ25)。

摘　　要：目的探讨基于单指数、双指数、拉伸指数模型的扩散加权成像(diffusion weighted imaging,DWI)在脑胶质瘤术前分级中的应用价值及相关性。方法回顾性分析31例脑胶质瘤患者的影像资料,分别进行单指数、双指数和拉伸指数模型的计算,对标准扩散系数(apparent diffusion coefficient,ADC)、快速扩散系数(fast ADC)、慢速扩散系数(slow ADC)、水分子扩散异质性指数α(water diffusion heterogeneityindex)和分布扩散指数(distribu-ted diffusion coefficient,DDC)进行记录和分析。结果标准ADC、slow ADC、α、DDC值均随着脑胶质瘤级别增加而减小,fast ADC随着脑胶质瘤级别增加而增加。标准ADC与slow ADC、α、DDC均呈正相关;slow ADC与DDC、α之间呈正相关;标准ADC、slow ADC、α、DDC值与脑胶质瘤级别均呈负相关,fastADC与脑胶质瘤级别呈正相关。ROC分析显示,在诊断低级别脑胶质瘤方面,标准ADC、α、DDC的曲线下面积较大,分别为0.878、0.826、0.809,fast ADC在诊断高级别脑胶质瘤的的曲线下面积为0.819。结论单指数、双指数、拉伸指数模型DWI可有效评估脑胶质瘤术前分级。Objective To investigate the applicability and correlation of diffusion weighted imaging(DWI)based on monoexponential,biexponential and stretched-exponential models for preoperative grading of glioma.Methods A ret-rospective analysis was performed based on imaging data from 31 brain glioma patients.The corresponding parameter val-ues of monoexponential,biexponential and stretched-exponential models were calculated.Then,the values of standard apparent diffusion coefficient(ADC),fast ADC,slow ADC,water diffusion heterogeneityindex(α)and distributed dif-fusion coefficient(DDC)were recorded and analyzed.Results The values of standard ADC,slow ADC,α,DDC de-creased with the increase in the grade of brain glioma,while the fast ADC increased with higher glioma grades.There was a significant positive correlation between standard ADC and slow ADC,α,DDC respectively.Additionally,a positive correlation was observed between slow ADC and DDC,slow ADC andα.The standard ADC,slow ADC,α,and DDC values were negatively correlated with brain glioma grades,whereas fast ADC showed a positive correlation with glioma grades.The ROC analysis revealed that for diagnosing low-grade brain gliomas,the area under the curve(AUC)for standard ADC,DDC andαwas at 0.878,0.826,and 0.809,respectively,which were relatively large.The AUC for fast ADC in diagnosing high-grade brain gliomas was 0.819.Conclusions DWI based on monoexponential,biexponential and stretched-exponential models is an effective tool for the preoperative grading of brain gliomas.

关 键 词：磁共振扩散加权成像 单指数 双指数 拉伸指数 脑胶质瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]