MRI征象联合ADC值对节细胞胶质瘤与少突胶质细胞瘤的鉴别诊断  

Differentiating ganglioglioma from oligodendroglioma using MRI features and ADC values

作　　者：董文洁 刘显旺 韩涛 周凤瑜 薛彩强 张斌 周俊林[1,2,3,4] DONG Wenjie;LIU Xianwang;HAN Tao;ZHOU Fengyu;XUE Caiqiang;ZHANG Bin;ZHOU Junlin(Department of Radiology,Second Hospital of Lanzhou University,Lanzhou 730000,China;Second Clinical College,Lanzhou University,Lanzhou 730000,China;Gansu Key Laboratory of Medical Imaging,Lanzhou 730000,China;Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Inelligence,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730000 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]甘肃省医学影像重点实验室,甘肃兰州730000 [4]医学影像人工智能甘肃省国际科技合作基地,甘肃兰州730000

出　　处：《中国中西医结合影像学杂志》2025年第2期197-202,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(82071872,82371914);中华国际医学交流基金会2021SKY影像科研基金(Z-2014-07-2101)。

摘　　要：目的:探讨MRI征象联合ADC值对节细胞胶质瘤与少突胶质细胞瘤的鉴别诊断价值。方法:回顾性分析经手术病理证实的12例节细胞胶质瘤(节细胞胶质瘤组)及18例少突胶质细胞瘤(少突胶质细胞瘤组)患者的临床、MRI及病理资料。比较2组肿瘤的MRI征象(肿瘤最大径、位置、瘤周水肿、形态、边界、囊变、囊性成分比例、出血、钙化、强化)。同时测定2组肿瘤的最大ADC(ADC_(max))、最小ADC(ADC_(min))、平均ADC(ADC_(mean))及标准化ADC(rADC)值。使用Fisher精确检验和独立样本t检验比较2组肿瘤MRI征象及ADC值差异,并绘制ROC曲线评估各参数模型鉴别2种肿瘤的诊断效能。结果:2组肿瘤最大径、囊性成分比例差异均有统计学意义(均P<0.05);性别、年龄、肿瘤位置、是否囊变、有无瘤周水肿、形态、边界、钙化、是否强化方面差异均无统计学意义(均P>0.05)。少突胶质细胞瘤组的ADC_(max)、ADC_(min)、ADC_(mean)及rADC值均大于节细胞胶质瘤组,差异均有统计学意义(均P<0.05)。ADC_(min)值诊断效能最优,AUC为0.933,当ADC_(min)阈值为1.134×10^(-3)mm^(2)/s时,鉴别两者的敏感度、特异度分别为77.8%、91.7%,准确率为83.33%。联合肿瘤最大径、囊性成分比例及各ADC值诊断效能进一步提升,AUC为0.958,准确率为93.33%。结论:MRI征象联合ADC值鉴别节细胞胶质瘤与少突胶质细胞瘤可提高术前诊断准确率,并可为临床决策提供指导。Objective:To evaluate the diagnostic value of MRI characteristics combined with ADC values in distinguishing ganglioglioma from oligodendroglioma.Methods:This retrospective study analyzed clinical,MRI,and histopathological data from 12 patients with ganglioglioma and 18 patients with oligodendroglioma.MRI features(tumor maximum diameter,location,peritumoral edema,shape,margin,cystic degeneration,cystic component ratio,hemorrhage,calcification,enhancement patterns)were compared between the two groups.The maximum ADC(ADCmax),minimum ADC(ADC_(min)),mean ADC(ADCmean)and standardized ADC(rADC)of the two groups were measured.Comparative analysis of MRI features and ADC values between the two groups were performed using Fisher’s exact test and independent t-tests.ROC curves were generated to evaluate differential diagnostic performance.Results:There were statistically significant differences in tumor maximum diameter and cystic component ratio between the two groups(both P<0.05),while there were no differences in gender,age,tumor location,cystic degeneration,peritumoral edema,shape,boundary,calcification and enhancement patterns between the two groups(all P>0.05).Oligodendrogliomas demonstrated significantly higher ADCmax,ADC_(min),ADCmean and rADC values compared to gangliogliomas(all P<0.05).ADC_(min)value showed optimal diagnostic efficiency,with an AUC of 0.933.When the threshold of ADC_(min)value was 1.134×10^(-3)mm^(2)/s,the sensitivity and specificity were 77.8%and 91.7%,respectively,and the accuracy was 83.33%.The diagnostic efficiency of combined tumor maximum diameter,cystic component ratio and ADC values was further improved,with an AUC of 0.958 and an accuracy of 93.33%.Conclusions:The integration of MRI features with ADC values enhances preoperatively differential diagnosis for ganglioglioma and oligodendroglioma,providing valuable guidance for clinical management.

关 键 词：节细胞胶质瘤 少突胶质细胞瘤 磁共振成像 扩散加权成像 表观扩散系数 

分 类 号：R73[医药卫生—肿瘤]