应用DTI-ALPS指数观察胶质瘤的脑胶质淋巴系统功能变化  

The Application of DTI-ALPS Index to Observe the Functional Changes of Glymphatic System in Glioma

作　　者：姜粲然 李若涵 沙静云 蔡璐璐 赵厚亮 孟冲 张超 徐凯 JIANG Canran;LI Ruohan;SHA Jingyun(Department of Radiology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province 211000,P.R.China)

机构地区：[1]徐州医科大学附属医院影像科,221000

出　　处：《临床放射学杂志》2024年第3期332-336,共5页Journal of Clinical Radiology

基　　金：江苏省老年健康科研课题基金资助项目(编号:LKM2023014);江苏省卫健委科研课题资助项目(编号:H2023134);徐州医科大学附属医院院级科研项目(编号:2020KA013)。

摘　　要：目的 利用沿血管周围间隙扩散张量成像(DTI-ALPS)指数评估脑胶质瘤患者的胶质淋巴系统(GS)功能变化,探索影响脑胶质瘤GS功能的因素。方法 回顾性纳入37例经手术病理证实为脑胶质瘤的住院患者和34名健康对照(HCs)。评估脑胶质瘤患者肿瘤的部位、大小、信号等常规影像特征后,经ITK-SNAP软件手动勾画胶质瘤瘤体与瘤周水肿(PTBE)并计算体积,测量所有受试者DTI参数值并计算出DTI-ALPS指数。利用t检验观察DTI-ALPS指数的组间差异,用Pearson相关分析观察DTI-ALPS指数与肿瘤体积、PTBE的相关性。结果 单因素方差分析显示,肿瘤同侧大脑半球的DTI-ALPS指数(1.23±0.16)显著低于对侧大脑半球(1.34±0.17)(P=0.014)与HCs (1.43±0.15)(P<0.001)。肿瘤对侧大脑半球与HCs的DTI-ALPS指数无显著差异(P=0.075)。肿瘤同侧大脑半球DTI-ALPS指数与PTBE体积呈显著负相关(P=0.008,r=-0.432)。结论 利用DTI-ALPS指数能够无创性评估脑胶质瘤GS的功能,且肿瘤同侧GS功能显著减低。PTBE是影响胶质瘤患者GS功能减低的重要因素。Objective To evaluate the functional changes of glymphatic system(GS) in patients with glioma by using diffusion tensor image analysis along the perivascular space(DTI-ALPS) index,and to explore the related factors affecting GS function of glioma.Methods Thirty-seven patients with pathologically confirmed glioma and 34 healthy controls(HCs) were included retrospectively.After evaluating the imaging features of glioma patients such as tumor location,size and signal,the tumor and peritumoral edema(PTBE) of glioma were manually delineated by ITK-SNAP software and the volume was calculated.The diffusion tensor imaging(DTI) parameters of all subjects were measured and the DTI-ALPS index was calculated.The t test was used to observe the difference between intergroups of DTI-ALPS index,and Pearson correlation analysis was used to observe the correlation between DTI-ALPS index and tumor volume and peritumoral edema(PTBE).Results The DTI-ALPS index(1.23±0.16) of the ipsilateral cerebral hemisphere was significantly lower than that of the contralateral cerebral hemisphere(1.34±0.17)(P=0.014) and HCs(1.43±0.15)(P< 0.001).There was no significant difference in DTI-ALPS index between the contralateral cerebral hemisphere and HCs(P=0.075).The ipsilateral DTI-ALPS index was negatively correlated with PTBE volume(P=0.008,r=-0.432).Conclusion The DTI-ALPS index could be used to evaluate the function of GS in glioma non-invasively,and the function of GS on the ipsilateral side of the tumor was significantly reduced.PTBE is an important factor affecting the GS function in patients with glioma.

关 键 词：胶质淋巴系统 脑胶质瘤 瘤周水肿 血管周围间隙 扩散张量成像 

分 类 号：R739.41[医药卫生—肿瘤]