| 黄琦,喻强,刘江,等.3.0T磁共振动态对比增强检查对脑胶质瘤分级诊断及其预后评估的价值[J].安徽医药,2021,25(9):1855-1858. |
| 3.0T磁共振动态对比增强检查对脑胶质瘤分级诊断及其预后评估的价值 |
| Grading diagnosis and prognosis evaluation of cerebral glioma with 3.0T dynamic contrast-enhanced magnetic resonance imaging |
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| DOI：10.3969/j.issn.1009-6469.2021.09.037 |
| 中文关键词: 神经胶质瘤 磁共振动态对比增强 分级诊断 预后评估 |
| 英文关键词: Glioma Dynamic contrast enhanced magnetic resonance imaging Grading diagnosis Prognosis evaluation |
| 基金项目: |
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| 摘要点击次数: 2023 |
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| 中文摘要: |
| 目的探究 3.0T磁共振动态对比增强检查在脑胶质瘤分级诊断及对其预后评估上的临床价值。方法选择 2015年 3月至 2018年 1月在宜宾市第一人民医院进行治疗的 87例脑胶质瘤病人作为研究对象，所有病人在治疗前接受磁共振动态对比增强检查( DCE-MRI)。分析低级别脑胶质瘤( LGG)、高级别脑胶质瘤( HGG)病人的容量转移常数( Ktrans)、速率常数( Kep)及血管外细胞外间隙容积分数( Ve)值，并就不同疗效病人之间的 Ktrans、Kep及 Ve值进行统计、比较。采用 ROC曲线分析对相关参数在评估脑胶质瘤病人预后上的临床价值。结果 LGG、HGG病人的 Kep值分别为( 1.452±0.271)/min、(1.511±0.292)/min，差异无统计学意义( P>0.05)； LGG病人的 Ktrans、Ve值分别为( 0.116±0.011)/min、(0.129±0.025)，明显低于 HGG病人的(0.251±0.083)/min、(0.313±0.041)(P<0.05)。预后良好组和预后较差组病人的 Kep值分别为( 1.456±0.228)/min、(1.502±0.236)/min，差异无统计学意义( P>0.05)，预后良好组病人的 Ktrans、Ve值分别为( 0.124±0.033)/min、(0.154±0.046)明显低于预后较差组的( 0.217±0.041)/min，(0.286±0.087)(P<0.05)。 ROC曲线评价结果显示， Ktrans、Ve在评价预后较差的脑胶，质瘤上的 AUC分别为 0.846、0.906，当其最佳阈值分别为 0.136、0.069时，其灵敏度分别为 78.85%、86.54%，特异度分别为 74.29%、82.86%，准确度分别为 77.01%、85.06%。结论 3.0T磁共振动态对比增强检查及定量参数有助于高、低级别脑胶质瘤的鉴别诊断，对于术前无创性评估脑胶质瘤病理分级及预后评估具有临床指导价值。 |
| 英文摘要: |
| Objective To explore the clinical value of 3.0T dynamic contrast-enhanced MRI in grading diagnosis and prognosis evaluation of cerebral glioma.Methods Totally 87 patients with cerebral glioma who were treated in The First People's Hospital ofYibin from March 2015 to January 2018 were selected as the research subjects. All patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before treatment. The volume transfer constant (Ktrans), the flux rate constant (Kep) and theextravascular extracellular volume fraction (Ve) values of patients with low grade glioma (LGG), high grade glioma (HGG) were analyzed, and the values of Ktrans, Kep and Ve in patients with different curative effects were compared. ROC curve analysis was made toevaluate the clinical value of relevant parameters in the prognosis of patients with cerebral glioma.Results There was no significant difference in Kep values between LGG and HGG groups [(1.452±0.271)/min vs. (1.511±0.292)/min, P>0.05]. The Ktrans and Ve values in LGG group were significantly lower than those in HGG group [(0.116±0.011)/min vs. (0.251±0.083)/min, (0.129±0.025) vs. (0.313± 0.041); P<0.05]. There was no significant difference in Kep values between patients with good prognosis and those with poor prognosis[(1.456±0.228)/min vs. (1.502±0.236)/min; P>0.05]. The Ktrans and Ve values of patients with good prognosis were significantly lowerthan those of patients with poor prognosis [(0.124±0.033)/min vs. (0.217±0.041)/min, (0.154±0.046) vs. (0.286±0.087); P<0.05]. The results of ROC curve analysis showed that AUCs of Ktrans and Ve were 0.846 and 0.906 respectively in glioma patients with poor prognosis. When the optimal thresholds were 0.136 and 0.069, the sensitivities, specificities, and accuracies of Ktrans and Ve were 78.85%,86.54% and 74.29%, 82.86% and 77.01%, 85.06%, respectively.Conclusion 3.0T dynamic contrast-enhanced MRI and quantitative parameters are helpful for the differentiation of high-grade and low-grade cerebral gliomas, and have clinical guiding value for noninvasive preoperative evaluation of pathological grade and prognosis of gliomas. |
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