合成MRI联合MUSE-DWI鉴别胶质瘤复发和治疗相关改变的应用研究  

Application of synthetic MRI combined with MUSE-DWI to differentiate glioma progressive disease from treatment-related changes

作　　者：吕瑞瑞 杨治花 党佩 黄雪莹[1] 马文富 金一萱 吕鸿洁 王晓东[1] LÜRuirui;YANG Zhihua;DANG Pei;HUANG Xueying;MA Wenfu;JIN Yixuan;LÜHongjie;WANG Xiaodong(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750003,China;Department of Radiotherapy,Cancer Hospital of Ningxia Medical University General Hospital,Yinchuan 750003,China;The First Clinical Medical College of Ningxia Medical University,Yinchuan 750003,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750003 [2]宁夏医科大学总医院肿瘤医院放疗科,银川750003 [3]宁夏医科大学第一临床医学院,银川750003

出　　处：《磁共振成像》2024年第7期81-86,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区自然科学基金项目(No.2023AAC03557);宁医大总院2023年新入职硕士人才培养项目(编号[:2023]394号)。

摘　　要：目的 探讨合成MRI定量参数联合多重灵敏度编码扩散加权成像(multiplexed sensitivity encoding diffusion weighted imaging, MUSE-DWI)鉴别胶质瘤复发(progressive disease, PD)和治疗相关改变(treatment-related change, TRC)的应用价值。材料与方法 本研究于2020年9月至2022年11月期间,依据纳、排标准收集胶质瘤全切术后行完整的放、化疗治疗,定期MRI随访出现新发强化灶的患者45例,其中PD组26例、TRC组19例。所有患者均行MUSE-DWI、合成MRI及对比增强T1加权成像(contrast enhanced T1-weighted imaging, CE_T1WI)序列。测量强化区域表观扩散系数(apparent diffusion coefficient,ADC)及增强前、后T1值(T1_(pre)、T1_(post))、T2值(T2_(pre)、T2_(post))。采用独立样本t检验或Mann-Whitney U检验比较合成MRI定量参数和ADC值的组间差异,采用二元logistic回归及受试者工作特征(receiver operating characteristic, ROC)曲线评估单参数及其联合的诊断效能。结果 (1)PD T1_(pre)高于TRC(P<0.05),T1_(post)和ADC值低于TRC(P<0.05),两组间T2_(pre)、T2_(post)差异无统计学意义(P>0.05)。(2)单参数分析时,ADC值诊断效能最高(AUC=0.878),其次是T1_(post)、T1_(pre)(AUC为0.783、0.745)。T1_(post)、T1_(pre)两者联合时,诊断效能较单参数提高(AUC=0.850)。多参数联合模型(T1_(post)+T1_(pre)+ADC)诊断效能最高(AUC=0.901)。结论 合成MRI定量参数(T1_(post)、T1_(pre))联合ADC值的多参数联合模型,在鉴别胶质瘤PD和TRC中具有一定价值。Objective:To assess the utility of synthetic MRI quantitative parameters and multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)in combination to differentiate glioma progressive disease(PD)from treatment-related change(TRC).Materials and Methods:In this study,we collected 45 patients who exhibited new enhancing lesions after surgery followed by completion of chemoradiation therapy from September 2020 to November 2022.The scan sequences included synthetic MRI,MUSE-DWI and contrast enhanced T1-weighted imaging(CE_T1WI).The patients were classified into two groups:PD group(n=26)and TRC group(n=19).The ROI is placed on each image to measure apparent diffusion coefficient(ADC),_(pre)-contrast T1,T2 value(T1_(pre),T2_(pre))and post-contrast T1,T2 value(T1_(post),T2_(post)).Quantitative parameters(T1_(pre),T2_(pre) and T1_(post),T2_(post))and ADC were evaluated using Student's t-test or Mann-Whitney U test.We generated receiver operating characteristic(ROC)curves for each parameter and their combinations.Finally,we used the area under the ROC curve(AUC)to assess the performance of each parameter and their combinations.Results:(1)The T1_(pre) value in the PD group were significantly higher than the TRC group(P<0.05).The values of T1_(post) and ADC in the PD group were significantly lower than the TRC group(all P<0.05).There was no statistical difference in T2_(pre),T2_(post) value(P>0.05).(2)ADC diagnostic performance was highest when using single parameter analysis(AUC=0.878),followed by T1_(post) and T1_(pre) with AUC of 0.783 and 0.745,respectively.The combinations of two parameters(T1_(pre)+T1_(post))improved the diagnostic performance(AUC=0.850)compared to the single parameter.A combined multi-parameter model(T1_(pre)+T1_(post)+ADC)was established with the highest diagnostic efficacy(AUC=0.901).Conclusions:The combinations of the two techniques to construct a multiparametric combined model of relaxation quantitative parameters(T1_(pre),T1_(post))combined with ADC values have a good diagnostic valu

关 键 词：胶质瘤 合成磁共振成像 磁共振成像 多重灵敏度编码 复发 治疗相关改变 

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]