多模态MRI在脑胶质瘤IDH基因分型中的应用价值  

The value of multimodal MRI in IDH genotyping of glioma

作　　者：熊瑞芳 朱涵婷 李承毅 唐小平[1] XIONG Ruifang;ZHU Hanting;LI Chengyi;TANG Xiaoping(Department of Radiology,the Second Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第二附属医院影像中心,江西南昌330000

出　　处：《医学影像学杂志》2024年第8期11-15,共5页Journal of Medical Imaging

基　　金：江西省卫生计生委科技计划项目(编号:202130443)。

摘　　要：目的 探讨无创反映脑胶质瘤细胞增殖及IDH基因表型的MRI特征。方法 选取我院经病理证实的120例脑胶质瘤患者临床及MRI资料,MRI检查包括常规平扫及增强扫描、DWI、DTI、MRS及3D ASL检查。应用免疫组化检测胶质瘤组织Ki-67表达情况,PCR测序法检测胶质瘤组织IDH1、P53的突变情况。所有数据处理应用SPSS26.0统计软件分析,P<0.05为差异有统计学意义。结果 Ki-67标记指数与强化、瘤周水肿、性质、年龄、病理学分级、肿瘤区rCBF值及水肿区rCBF值呈正相关(P<0.05),IDH1~(mut)与IDH1~(wild)胶质瘤组间强化程度、T_2-FLAIR失配征、肿瘤区rCBF值、水肿区rCBF值、瘤体区rADC_(min)值及肿瘤区Cho/NAA比值差异均有统计学意义(P<0.05),胶质瘤P53突变状态与性别、性质、肿瘤区rCBF值及rFA_(mean)差异均有统计学意义(P<0.05)。结论 术前肿瘤区rCBF值有助于胶质瘤IDH1基因分型,预测Ki-67基因表达程度。T_2-FLAIR失配征、rCBF值可成为评价IDH1基因表型MRI特征。Objective To find MRI features that noninvasively reflect the cell proliferation,and IDH genotype of glioma.Methods We retrospectively analyzed 120 patients with glioma confirmed by postoperative pathology in our hospital.MRI ex-aminations included head routine scans,enhanced scans,DWI,DTI,MRS,and 3D ASL.Immunohistochemistry was applied to detect Ki-67 expression in glioma,and PCR sequencing was applied to detect IDH1 and P53 mutations in glioma.All data were analyzed by SPSS26.0 statistical software,and the difference was considered statistically significant at P<0.05.Results Ki-67 labeling index was positively correlated with enhancement,peritumoral edema,nature,age,pathological grade and rCBF value in tumor area and edema area(P<0.05).The degree of enhancement,T_(2)-FLAIR mismatch sign,tumor area and edema area rCBF value,rADCmin value in the tumor area and Cho/NAA ratio in the tumor area were statistically different between IDH1mut and IDH1wild glioma groups(P<0.05).The P53 mutation status of glioma was statistically significant with respect to gen-der,nature,rCBF value in the tumor area and rFAmean(P<0.05).Conclusion Preoperative tumor area rCBF value can help glioma IDH1 genotyping and predict the degree of Ki-67 gene expression.T2-FLAIR mismatch sign and rCBF value can be MRI features to evaluate IDH1 genotype.

关 键 词：胶质瘤 磁共振成像 异柠檬酸脱氢酶 P53基因 Ki-67增殖指数 

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]