[1]张磊,杨柳青,龚明福,等.体素不相干运动扩散加权磁共振成像在脑胶质瘤术前分级诊断中的应用价值[J].第三军医大学学报,2016,38(22):2407-2412.
 Zhang Lei,Yang Liuqing,Gong Mingfu,et al.Value of intravoxel incoherent motion diffusion-weighted MR imaging in preoperative glioma grading[J].J Third Mil Med Univ,2016,38(22):2407-2412.
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体素不相干运动扩散加权磁共振成像在脑胶质瘤术前分级诊断中的应用价值(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第22期
页码:
2407-2412
栏目:
专题报道
出版日期:
2016-11-30

文章信息/Info

Title:
Value of intravoxel incoherent motion diffusion-weighted MR imaging in preoperative glioma grading
作者:
张磊杨柳青龚明福文利王光宪张冬
第三军医大学新桥医院放射科
Author(s):
Zhang LeiYang LiuqingGong MingfuWen LiWang GuangxianZhang Dong

Department of Radiology,Xinqiao Hospital,Third Military Medical University,Chongqing, 400037,China

关键词:
磁共振成像胶质瘤扩散加权成像体素内不相干运动多b值
Keywords:
MRIgliomasdiffusion weighted imaging intravoxel incoherent motion multi-b value
分类号:
R445.2;R730.264;R730.4
文献标志码:
A
摘要:

目的       探讨多b值体素不相干运动扩散加权磁共振成像(intravoxel incoherent motion MR imaging,IVIM-MRI)在胶质瘤术前分级诊断中的应用价值。方法      纳入本院经手术病理确诊脑胶质瘤患者40例(低级别18例,高级别22例),术前行常规MR平扫、增强及多b值IVIM序列扫描,IVIM图像经后处理工作站分析,分别测量肿瘤实质区、瘤周区及对侧正常半卵圆中心的ADCstandard、慢速扩散系数D(slow ADC)、快速扩散系数D* (fast ADC)以及灌注分数f(fraction of fast ADC)值。所得数据经统计软件进行组间比较并与病理分级进行相关性分析。结果       40例胶质瘤患者肿瘤实质区、瘤周区的ADCstandard、D、D*值均明显高于对侧半卵圆中心;肿瘤实质区D、D*值高于瘤周区,差异均有统计学意义(P<0.05)。高级别肿瘤实质区ADCstandard值[(1.09±0.22) vs(1.48±0.32)×10-3 mm2/s,t=4.391,P<0.05]、D值[(0.78±0.17) vs (1.21±0.23)×10-3mm2/s,t=6.236,P<0.05]显著低于低级别者;高级别者肿瘤实质区D*值[(32.65±9.91) vs (17.12±7.74)×10-3mm2/s,t=-5.290,P<0.05]、f值[(0.47±0.08) vs (0.29±0.07),t=-7.177,P<0.05]显著高于低级别者。通过Pearson相关性分析发现高、低级别肿瘤分级与ADCstandard、D值呈负相关,与D*、f值呈正相关;根据高、低级别胶质瘤肿瘤实质区的ADCstandard、D、D*、f值绘制ROC曲线,其曲线下面积及诊断阈值分别为ADCstandard(0.851,1.23×10-3 mm2/s)、D(0.939,0.92×10-3 mm2/s)、D*(0.899,20.6×10-3 mm2/s)、f(0.957,0.36)。结论      多b值IVIM-MRI所得ADCstandard、D、D*、f值在高、低级别胶质瘤中存在统计学差异,有利于术前安全无创地检测胶质瘤扩散及灌注信息判断其级别。

Abstract:

Objective      To investigate the application value of multi-b intravoxel incoherent motion (IVIM) diffusion-weighted MR imaging for preoperative evaluation of tumor grade in gliomas. Methods      Forty patients with pathologically confirmed gliomas (18 cases of low grade and 22 cases of high grade) admitted in our hospital from July 2015 to July 2016 were enrolled in this study. They received conventional MR plain scanning, enhanced scanning and multi-b of IVIM sequences scanning. Four parameters including apparent diffusion coefficient (ADC) standard, slow diffusion coefficient (D), fast diffusion coefficient (D*) and fraction of fast perfusion fraction (f) were measured in the 3 areas, i.e., tumor parenchyma region, periphery surrounding the tumor and the semioval center of contralateral side. The data was compared between low and high grade gliomas and correlation of the parameters to the pathological grade was analyzed. Results      In all patients, the values of ADCstandard, D and D* in tumor parenchyma and peripheral regions were significantly higher than in the semioval center of contralateral side. Also, the D and D* values were significantly higher in tumor parenchyma region compared with periphery region (P<0.05). The value of ADCstandard, D, D*, and f in high and low grade gliomas were (1.09±0.22,1.48±0.32)×10-3 mm2/s, (0.78±0.17,1.21±0.23)×10-3 mm2/s, (32.65±9.91,17.12±7.74)×10-3 mm2/s, (0.47±0.08,0.29±0.07), respectively. Compared with low grade group, high grade glioma patients had significant lower value of ADCstandard and D (t=4.391 and t=6.236) but higher D* and f (t=-5.290 and t=-7.177) in tumor parenchyma area (P<0.05). The Pearson correlation analysis illustrated that the ADCstandard and D values were negatively related to glioma grade whereas D* and f were positively associated. In addition, the receiver operating characteristic (ROC) analysis showed that the area under the curve and the diagnostic threshold for ADCstandard, D, D* and f were (0.851,1.23×10-3 mm2/s), (0.939,0.92×10-3 mm2/s), (0.899,20.6×10-3 mm2/s), and (0.957,0.36), respectively. Conclusion     Our data demonstrated significant difference of ADCstandard, D, D* and f between high and low grade gliomas measured by multi-b IVIM MR imaging. This non-invasive IVIM imaging can detect diffusion and perfusion changes in tissue, which may be useful for preoperative evaluation of tumor grade in gliomas.

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更新日期/Last Update: 2016-11-23