多模态多参数磁共振成像在脑胶质瘤Ki-67表达中的研究  

Research of Ki-67 expression in glioma by multimodal multi-parameter magnetic resonance imaging

作　　者：周佳南 朱正阳 田传帅 杨惠泉[2] 陈思璇 叶梅萍 张鑫 张冰 ZHOU Jianan;ZHU Zhengyang;TIAN Chuanshuai;YANG Huiquan;Chen Sixuan;YE Meiping;ZHANG Xin;ZHANG Bing(Department of Radiology,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China;Department of Radiology,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院医学影像科,南京210008 [2]南京大学医学院附属鼓楼医院医学影像科,南京210008

出　　处：《磁共振成像》2024年第5期34-40,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：江苏省研究生科研与实践创新计划项目(编号:JX22014155);南京鼓楼医院临床研究专项资金项目(编号:2022-LCYJ-MS-25)。

摘　　要：目的探讨多模态磁共振成像技术及其定量和定性参数预测胶质瘤Ki-67表达水平的价值。材料与方法选取330例胶质瘤患者,其中异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)野生型201例,IDH突变型129例。获得常规MRI特征、表观扩散系数(apparentdiffusion coefficient,ADC)、动态对比增强(dynamic contrast-enhanced,DCE)MRI定性及定量参数时间-强度曲线(time-intensity curve,TIC)、转运常数(volume transfer constant,K^(trans))、渗出速率常数(the rate constant,K_(ep))、血管外细胞外容积分数(fractional volume of the extravascular-extracellular,V_(e))、血浆分数(plasma fraction,V_(p))及磁共振波谱(magnetic resonance spectroscopy,MRS)代谢产物比值,对胶质瘤患者进行logistic回归,以确定与Ki-67表达水平相关因素。用受试者工作特征曲线下面积(area under the curve,AUC)评价预测模型的性能。结果在胶质瘤患者分析中,K^(trans)(OR=1.012,P<0.001)、ADC(OR=0.998,P<0.05)、强化程度(OR=3.317,P<0.05)是Ki-67表达水平的独立预测因素,AUC为0.893。结论K^(trans)、ADC和强化程度可能是预测胶质瘤Ki-67表达水平的有效参数。Objective:To investigate the prediction of Ki-67 expression in glioma by multi-modal magnetic resonance imaging and quantitative and qualitative parameters.Materials and Methods:Three hundred and thirty patients with glioma were selected,including 201 patients with isocitrate dehydrogenase(IDH)wild type and 129 patients with IDH mutant type.Conventional MRI features,apparent diffusion coefficient(ADC),qualitative and quantitative parameters of dynamic contrast-enhanced(DCE)MRI such as time-intensity curves(TIC),volume transfer constant(K^(trans)),the rate constant(K_(ep)),fractional volume of the extravascular-extracellular(V_(e)),plasma fraction(V_(p))and magnetic resonance spectroscopy(MRS)metabolites were obtained.Logistic regression was performed for all gliomas to identify factors associated with Ki-67 expression.The area under receiver operating characteristic curve(AUC)was used to evaluate the performance of the prediction model.Results:In glioma patients'analyses,K^(trans)(OR=1.012,P<0.001),ADC(OR=0.998,P<0.05),enhancement degree(OR=3.317,P<0.05)were independent predictors of Ki-67 expression level,and AUC value is 0.893,respectively.Conclusions:K^(trans),ADC and enhancement may be effective parameters for predicting Ki-67 expression level in glioma.

关 键 词：胶质瘤 磁共振成像 多模态 KI-67 异柠檬酸脱氢酶 

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]