磁共振扩散加权成像对不同级别脑膜瘤的诊断价值分析  

Analysis of the Diagnostic Value of Magnetic Resonance Diffusion-Weighted Imaging for Meningiomas of Different Grades

作　　者：许帅 王亚峰 洪晓雪 王朋[1] XU Shuai;WANG Yafeng;HONG Xiaoxue;WANG Peng(The First Affiliated Hospital of USTC(Anhui Provincial Hospital),Hefei,Anhui 230000,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院),安徽合肥230000

出　　处：《生物医学工程学进展》2024年第4期293-298,共6页Progress in Biomedical Engineering

摘　　要：目的探讨磁共振扩散加权成像(DWI)对不同级别脑膜瘤的诊断价值,为脑膜瘤的术前评估和分级提供影像学依据。方法回顾性分析2020年4月至2024年2月在中国科学技术大学附属第一医院(安徽省立医院)接受手术治疗并经病理确诊的80例脑膜瘤患者的临床和影像学资料。根据2016年WHO中枢神经系统肿瘤分类标准,将患者分为低级别组(WHOⅠ级,40例)和高级别组(WHOⅡ级和Ⅲ级,40例)。所有患者均在术前1周内接受3.0T MRI扫描,包括常规序列和DWI序列。测量肿瘤实质部分的平均表观扩散系数(ADC_(mean))、最小表观扩散系数(ADC_(min))及对侧正常白质ADC值。采用独立样本t检验比较两组间差异,并使用ROC曲线分析各ADC参数对脑膜瘤分级的诊断效能。结果①低级别组和高级别组在ADC_(mean)、ADC_(min)和对侧正常白质ADC值上均存在显著差异(P<0.05)。低级别组的ADC_(mean)、ADC_(min)和对侧正常白质ADC值均高于高级别组(t=2.037、2.586、2.795;P=0.045、0.012、0.007)。②ROC曲线分析显示,ADC_(mean)、ADC_(min)、对侧正常白质ADC及联合预测因子的曲线下面积(AUC)分别为0.637、0.659、0.690和0.767,均具有一定的诊断价值(P<0.05)。③联合预测因子的诊断效能最佳,其特异度为0.850,约登指数为0.425,截断值为3.299。对侧正常白质ADC值在敏感度方面表现最佳,为0.650。结论磁共振扩散加权成像对脑膜瘤的术前分级具有重要的诊断价值。ADC_(mean)、ADC_(min)和对侧正常白质ADC值可作为鉴别低级别和高级别脑膜瘤的影像学指标。联合应用这些参数可以提高诊断的准确性,为临床制订个体化治疗方案提供重要参考。Objective To explore the diagnostic value of magnetic resonance diffusion-weighted imaging(DWI)for meningiomas of different grades,providing imaging evidence for preoperative assessment and grading of meningiomas.Methods A retrospective analysis was conducted on the clinical and imaging data of 80 patients with meningiomas who underwent surgical treatment and were pathologically confirmed in The First Affiliated Hospital of USTC(Anhui Provincial Hospital)from April 2020 to February 2024.According to the 2016 WHO classification of central nervous system tumors,patients were divided into a low-grade group(WHO gradeⅠ,40 cases)and a high-grade group(WHO gradesⅡandⅢ,40 cases).All patients underwent 3.0T MRI scans within one week before surgery,including conventional sequences and DWI sequences.The mean apparent diffusion coefficient(ADC_(mean)),minimum apparent diffusion coefficient(ADC_(min)),and ADC values of the contralateral white matter were measured.Independent sample t-tests were used to compare differences between the two groups,and ROC curve analysis was performed to evaluate the diagnostic efficiency of each ADC parameter for meningioma grading.Results①Significant differences were found in ADC_(mean),ADC_(min),and contralateral white matter ADC values between the low-grade and high-grade groups(P<0.05).The low-grade group had higher ADC_(mean),ADC_(min),and contralateral white matter ADC values than the high-grade group(t=2.037,2.586,2.795;P=0.045,0.012,0.007).②ROC curve analysis showed that the area under the curve(AUC)for ADC_(mean),ADC_(min),contralateral white matter ADC,and their combined predictive factors were 0.637,0.659,0.690,and 0.767,respectively,all demonstrating certain diagnostic value(P<0.05).③The combined predictive factor showed the best diagnostic efficiency,with a specificity of 0.850,a Youden index of 0.425,and a cutoff value of 3.299.The contralateral white matter ADC demonstrated the best sensitivity,at 0.650.Conclusions Magnetic resonance diffusion-weighted imaging has sign

关 键 词：脑膜瘤 磁共振成像 扩散加权成像 表观扩散系数 分级诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]