合成MRI联合酰胺质子转移成像在预测脑胶质瘤IDH1基因状态中的应用价值  

The value of synthetic MRI combined with amide proton transfer imaging in projecting IDH1 genestate in gliomas

作　　者：孙萌 马文富 葛鑫 金一萱 牛芳 党佩 周嘉鑫 王晓东[3,4] SUN Meng;MA Wenfu;GE Xin;JIN Yixuan;NIU Fang;DANG Pei;ZHOU Jiaxin;WANG Xiaodong(Clinical Medical College,Ningxia Medical University,Yinchuan 750004,China;The Second Clinical Medical College of Lanzhou University,Lanzhou 730030,China;Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Key Laboratory of Craniofacial Diseases,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学临床医学院,银川750004 [2]兰州大学第二临床医学院,兰州730030 [3]宁夏医科大学总医院放射科,银川750004 [4]宁夏医科大学颅脑疾病重点实验室,银川750004

出　　处：《磁共振成像》2024年第11期60-66,109,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区自然科学基金项目(编号:2022AAC03487);宁夏回族自治区科技重点研发计划项目(编号:2019BEG03037)。

摘　　要：目的探讨合成磁共振成像(synthetic magnetic resonance imaging,syMRI)联合酰胺质子转移(amide proton transfer,APT)成像在预测脑胶质瘤异柠檬酸脱氢酶1(isocitrate dehydrogenase 1,IDH1)基因状态中的应用价值。材料与方法回顾性分析2019年7月至2023年12月在宁夏医科大学总医院诊断为胶质瘤并具有完整病理资料的患者病例97例,其中IDH1突变型(IDH1 mutant,IDH1-mut)57例,IDH1野生型(IDH1 wildtype,IDH1-wt)40例,所有患者术前均接受增强前后的syMRI及APT扫描,并测量其定量参数T1-pre、T2-pre、T1-post、T2-post与APT值。使用独立样本t检验或Mann-Whitney U检验比较组间各参数的差异,运用受试者工作特征曲线和二元logistic回归分析各单一参数及联合参数对IDH1基因状态的诊断效能。DeLong检验用于比较各参数AUC的差异。结果IDH1-wt胶质瘤APT值、T1-pre高于IDH1-mut胶质瘤(P均<0.05);IDH1-wt胶质瘤T1-post、T2-post低于IDH1-mut胶质瘤(P均<0.01);T2-pre在两组间的差异无统计学意义(P=0.107)。在所有单一参数中,APT值对IDH1-mut与IDH1-wt胶质瘤的诊断效能最高,AUC为0.867,高于T1-pre、T1-post、T2-post(AUC分别为0.620、0.811、0.723);多参数联合预测模型(T1-pre+T1-post+T2-post+APT)的AUC为0.886,敏感度为80.7%,特异度为85.0%,高于任何单一参数。DeLong检验结果显示多参数联合预测模型的诊断效能优于T1-pre、T1-post、T2-post值(P均<0.05),而与APT的AUC无显著差异(P=0.208)。结论syMRI联合APT有助于术前无创预测脑胶质瘤IDH1基因状态,两者联合应用诊断时效能最高。Objective:To explore the value of synthetic magnetic resonance imaging(syMRI)combined with amide proton transfer(APT)in projecting the isocitrate dehydrogenase 1(IDH1)gene status in gliomas.Materials and Methods:A retrospective analysis was performed on 97 patients diagnosed with glioma with complete pathological data at the General Hospital of Ningxia Medical University from July 2019 to December 2023,including 57 cases of IDH1 mutant(IDH1-mut)and 40 cases of IDH1 wildtype(IDH1-wt),all of whom underwent preoperative pre-and post-contrast syMRI and APT scans,and their quantitative parameters T1-pre,T2-pre,T1-post,T2-post and APT values were measured.Independent samples t-tests or Mann-Whitney U-tests were used to analyse the differences between groups for each parameter,and the diagnostic efficacy of each single and combined parameter for IDH1 gene status was assessed using subject operating characteristic curves and binary logistic regression analyses.The DeLong test was used to compare the differences in AUC for each parameter.Results:APT values and T1-pre were higher in IDH1-wt than in IDH1-mut gliomas(P<0.05);T1-pre and T2-pre were lower in IDH1-wt gliomas than in IDH1-mut gliomas(P<0.01);and T2-pre was not statistically significant between the two groups(P=0.107).Among all single parameters,the APT value had the highest diagnostic efficacy for IDH1-mut versus IDH1-wt glioma,with an AUC of 0.867,which was higher than that of T1-pre,T1-post,and T2-post(AUC 0.620,0.811,and 0.723);the AUC of the multi-parameter combined prediction model(T1-pre+T1-post+T2-post+APT)had an AUC of 0.886,a sensitivity of 80.7%,and a specificity of 85.0%,which was higher than that of any single parameter.The DeLong test showed that the diagnostic efficacy of the multi-parameter combined prediction model was superior to the T1-pre,T1-post,and T2-post values(P<0.05),whereas there was no significant difference in the AUC with APT(P=0.208).Conclusions:syMRI combined with APT is useful for preoperative noninvasive prediction of IDH1 gene s

关 键 词：胶质瘤 磁共振成像 合成磁共振成像 酰胺质子转移成像 异柠檬酸脱氢酶1 预测 

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]