基于血流的血管空间占位和弥散加权成像在胶质瘤术前分级中的附加价值。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Neurodegenerative Diseases Pub Date : 2020-01-01 Epub Date: 2021-03-18 DOI:10.1159/000512545

Haimei Cao, Xiang Xiao, Jun Hua, Guanglong Huang, Wenle He, Jie Qin, Yuankui Wu, Xiaodan Li

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引用次数: 1

摘要

目的:本研究旨在研究基于血流的血管空间占用(iVASO) MR成像(MRI)和弥散加权成像(DWI)联合成像是否能提高胶质瘤术前分级的诊断准确性。方法:51例经组织病理学证实的弥漫性胶质瘤患者术前行结构MRI、iVASO和DWI检查。我们进行了2次定性一致的回顾:(1)单独的结构MR图像和(2)结构MR图像与iVASO和DWI。比较低级别和高级别胶质瘤的相对小动脉脑血容量(rCBVa)和最小表观扩散系数(mADC)。采用受试者工作特征(Receiver operating characteristic, ROC)曲线分析，比较rCBVa、mADC及两者联合的肿瘤分级效率。结果:在第一次回顾中，51例患者中有40例(78.4%)有两名观察员诊断出准确的肿瘤分级，在第二次回顾中，51例患者中有46例(90.2%)有两名观察员诊断出准确的肿瘤分级。rCBVa和mADC在低级别和高级别胶质瘤中均表现出显著差异。ROC分析显示，rCBVa的阈值为1.52,mADC的阈值为0.85 × 10-3 mm2/s，敏感性和特异性分别为88.0和81.2%，100.0和68.7%。rCBVa和mADC的ROC曲线下面积(AUC)分别为0.87和0.85。rCBVa和mADC值联合使AUC增加到0.92。结论:iVASO与DWI联合应用可提高胶质瘤分级的诊断准确性。

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The Added Value of Inflow-Based Vascular-Space-Occupancy and Diffusion-Weighted Imaging in Preoperative Grading of Gliomas.

Objectives: The present study aimed to study whether combined inflow-based vascular-space-occupancy (iVASO) MR imaging (MRI) and diffusion-weighted imaging (DWI) improve the diagnostic accuracy in the preoperative grading of gliomas.

Methods: Fifty-one patients with histopathologically confirmed diffuse gliomas underwent preoperative structural MRI, iVASO, and DWI. We performed 2 qualitative consensus reviews: (1) structural MR images alone and (2) structural MR images with iVASO and DWI. Relative arteriolar cerebral blood volume (rCBVa) and minimum apparent diffusion coefficient (mADC) were compared between low-grade and high-grade gliomas. Receiver operating characteristic (ROC) curve analysis was performed to compare the tumor grading efficiency of rCBVa, mADC, and the combination of the two parameters.

Results: Two observers diagnosed accurate tumor grade in 40 of 51 (78.4%) patients in the first review and in 46 of 51 (90.2%) in the second review. Both rCBVa and mADC showed significant differences between low-grade and high-grade gliomas. ROC analysis gave a threshold value of 1.52 for rCBVa and 0.85 × 10-3 mm2/s for mADC to provide a sensitivity and specificity of 88.0 and 81.2% and 100.0 and 68.7%, respectively. The area under the ROC curve (AUC) was 0.87 and 0.85 for rCBVa and mADC, respectively. The combination of rCBVa and mADC values increased the AUC to 0.92.

Conclusion: The combined application of iVASO and DWI may improve the diagnostic accuracy of glioma grading.

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来源期刊

Neurodegenerative Diseases 医学-临床神经学

CiteScore

5.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Neurodegenerative Diseases'' is a bimonthly, multidisciplinary journal for the publication of advances in the understanding of neurodegenerative diseases, including Alzheimer''s disease, Parkinson''s disease, amyotrophic lateral sclerosis, Huntington''s disease and related neurological and psychiatric disorders.