基于平均表观传播子磁共振成像鉴别WHO CNS4R较低级别胶质瘤中的CNS5胶质母细胞瘤  

Identification of CNS5 glioblastoma in lower-grade gliomas of the WHO CNS4R based on mean apparent propagator-magnetic resonance imaging

作　　者：肖慧楠 郑莞怡 吴振兴 施宇婷 徐雪 蒋日烽[2] XIAO Huinan;ZHENG Wanyi;WU Zhenxing;SHI Yuting;XU Xue;JIANG Rifeng(Department of Radiotherapy,Fujian Medical University Union Hospital,Fujian,Fuzhou 350001,China;Department of Radiology,Fujian Medical University Union Hospital,Fujian,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院放疗科,福建福州350001 [2]福建医科大学附属协和医院放射科,福建福州350001

出　　处：《中国医药科学》2024年第7期139-143,共5页China Medicine And Pharmacy

基　　金：福建省卫生健康中青年骨干人才培养项目(2022GGA013)。

摘　　要：目的探讨平均表观传播子磁共振成像(MAP-MRI)从2016年WHO CNS4R分类下较低级别胶质瘤中鉴别2021年WHO CNS5分类的胶质母细胞瘤(GBM)的价值及意义。方法选取2019年1月至2022年12月于福建医科大学附属协和医院诊疗的28例WHO CNS4R分类为WHOⅡ或Ⅲ级脑弥漫性胶质瘤成人患者为研究对象。所有患者术前均行结构磁共振成像和扩散磁共振成像,其中扩散磁共振成像分别行MAPMRI和扩散张量成像(DTI)分析,并提取肿瘤实体区的均方位移(MSD)、q空间逆方差(QIV)、回归轴概率(RTAP)、回归原点概率(RTOP)、回归平面概率(RTPP)及平均扩散率(MD)均值。术后行病理和基因检测,再根据WHO CNS5分类重新分为GBM组(n=6)和非GBM组(n=22)。使用Mann-Whitney U检验比较两组MSD、QIV、RTAP、RTOP、RTPP及MD值的差异,并进一步绘制受试者工作特征曲线(ROC)评价其对GBM的诊断效能。结果两组肿瘤实体区的QIV、RTAP和MD值比较,差异有统计学意义(P<0.05),其中QIV和RTAP的差异最为显著,受试者工作特征曲线(ROC)的曲线下面积(AUC)均为0.78,特异度均为54.50%,敏感度均为100.00%。结论MAP-MRI在一定程度上具备从WHO CNS4R较低级别胶质瘤中鉴别CNS5胶质母细胞瘤的能力,其中QIV和RTAP的诊断效能最佳。Objective To explore the value and significance of mean apparent propagator-magnetic resonance imaging(MAP-MRI)in identifying glioblastoma(GBM)classified by WHO CNS5 in 2021 from lower-grade gliomas classified by WHO CNS4R in 2016.Methods A total of 28 adult patients with WHO gradeⅡorⅢdiffuse gliomatosis cerebri classified by WHO CNS4R who were diagnosed and treated at Fujian Medical University Union Hospital from January 2019 to December 2022 were selected for the study.All patients underwent preoperative structural magnetic resonance imaging and diffusion magnetic resonance imaging.For diffusion magnetic resonance imaging,MAP-MRI and diffusion tensor imaging(DTI)were performed separately,and mean values of the mean square displacement(MSD),q-space inverse variance(QIV),return to the axis probability(RTAP),return to the origin probability(RTOP),return to the plane probability(RTPP),and mean diffusivity(MD)of the tumor solid area were extracted.Postoperative pathology and genetic testing were performed and then the patients were reclassified into the GBM group(n=6)and the non-GBM group(n=22)according to WHO CNS5 classification.Mann Whitney U-test was used to compare the differences in the values of MSD,QIV,RTAP,RTOP,RTPP,and MD between the two groups,and the receiver operating characteristic curve(ROC)was further plotted to evaluate its diagnostic efficacy in GBM.Results There were statistically significant differences in the values of QIV,RTAP,and MD in the solid tumor area between the two groups(P<0.05),with the most significant difference being between QIV and RTAP.The area under the curve(AUC)of receiver operator characteristic curve(ROC)was 0.78,with a specificity of 54.50%and a sensitivity of 100.00%.Conclusion MAP-MRI can differentiate CNS5 glioblastoma from lower-grade gliomas of WHO CNS4R to a certain extent,with QIV and RTAP having the best diagnostic ef ficacy.

关 键 词：磁共振成像 平均表观传播子磁共振成像 胶质母细胞瘤 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]