杨婷,顾太富,张冉,肖新兰.三维伪连续式动脉自旋标记及体素内不相干运动成像评估脑胶质瘤IDH1基因分型[J].中国医学影像技术,2021,37(7):979~983
三维伪连续式动脉自旋标记及体素内不相干运动成像评估脑胶质瘤IDH1基因分型
Three-dimensional pseudo-continuous arterial spin labeling and intravoxel incoherent motion imaging in evaluating IDH1 genotyping of gliomas
投稿时间:2020-06-05  修订日期:2021-05-15
DOI:10.13929/j.issn.1003-3289.2021.07.004
中文关键词:  胶质瘤  磁共振成像  连续式动脉自旋标记  体素内不相干运动  异柠檬酸脱氢酶1
英文关键词:glioma  magnetic resonance imaging  continuous arterial labeling  intravoxel incoherent motion imaging  isocitrate dehydrogenase-1
基金项目:江西省重点研发计划(20171ACG70002)、江西省卫生健康委科技计划(20204276)。
作者单位E-mail
杨婷 南昌大学第二附属医院影像中心, 江西 南昌 330006  
顾太富 南昌大学第二附属医院影像中心, 江西 南昌 330006  
张冉 南昌大学第二附属医院影像中心, 江西 南昌 330006  
肖新兰 南昌大学第二附属医院影像中心, 江西 南昌 330006 jx_xiaoxinlan@sina.com 
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中文摘要:
      目的 对比术前三维伪连续式动脉自旋标记(3D-pCASL)及体素内不相干运动成像(IVIM)术前判断脑胶质瘤异柠檬酸脱氢酶1(IDH1)基因分型的价值。方法 回顾性分析78例经病理证实且有IDH1基因检测结果脑胶质瘤患者的临床及术前3D-pCASL及IVIM资料,将患者分为IDH1野生组(野生组,n=51)及IDH1突变组(突变组,n=27)。野生组中41例高级别、10例低级别胶质瘤,突变组中11例高级别,16例低级别胶质瘤。比较2组临床资料及3D-pCASL参数[最大脑血流量(CBFmax)、相对CBF(rCBF)]、IVIM参数[最小真扩散系数(Dmin)、最大伪扩散系数(D*max)及最大灌注分数(fmax)]的差异,针对差异有统计学意义参数,绘制其鉴别胶质瘤IDH1突变情况的受试者工作特征(ROC)曲线,评价其诊断效能。结果 2组性别差异无统计学意义(P=0.970),野生组患者年龄高于突变组(P=0.040)、高级别胶质瘤占比高于突变组(P<0.001)。野生组肿瘤CBFmax、rCBF均高于突变组(P均<0.05),而Dmin、D*max、fmax组间差异均无统计学意义(P均>0.05)。CBFmax、rCBF鉴别胶质瘤IDH1野生型与突变型的曲线下面积分别为0.71、0.73,CBFmax阈值为91.28 ml/(100 g·min)时,诊断敏感度、特异度分别为74.10%、74.50%;rCBF阈值为1.53时,其诊断敏感度、特异度分别为55.60%、84.30%。结论 脑胶质瘤3D-pCASL参数CBFmax、rCBF对判断IDH1基因分型具有一定效能;IVIM参数的稳定性欠佳,其价值有待进一步观察。
英文摘要:
      Objective To compare the value of three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) and intra voxel incoherent motion imaging (IVIM) in preoperative identifying the genotyping of isocitrate dehydrogenase 1 (IDH1) of brain gliomas. Methods The clinical and preoperative 3D-pCASL and IVIM data of 78 patients with pathologically confirmed glioma and IDH1 immunohistochemical results were retrospectively analyzed. The patients were divided into IDH1 wild group (wild group,n=51) and IDH1 mutant group (mutant group,n=27). There were 41 cases of high-grade gliomas (HGG) and 10 of low-grade gliomas (LGG) in wild group, 11 HGG and 16 LGG in mutant group. The clinical data and 3D-pCASL parameters (maximum cerebral blood flow [CBFmax], relative CBF [rCBF]), IVIM parameters (minimum true diffusion coefficient [Dmin], maximum pseudo diffusion coefficient [D*max] and perfusion fraction [fmax]) were compared between groups. Receiver operating characteristic (ROC) curves of parameters being statistically different between groups were drawn for predicting IDH1 mutation genotyping of gliomas, and the corresponding diagnostic efficacies were analyzed. Results There was no difference of gender between groups (P=0.970), while the age of patients in wild group was higher than those in mutant group (P=0.040). The proportion of HGG was higher in wild group than that mutant group (P<0.001). CBFmax and rCBF in wild group were higher than those in mutant group (both P<0.05), while Dmin, D*max and fmax were no difference between groups (all P>0.05). The area under the curve (AUC) of CBFmax and rCBF for differential diagnosis of IDH1 wild and IDH1 mutant in glioma was 0.71 and 0.73, respectively. Taken 91.28 ml/(100 g·min) as the threshold of CBFmax,the sensitivity and specificity was 74.10% and 74.50%, respectively, while taken 1.53 as the threshold of rCBF, the sensitivity and specificity was 55.60% and 84.30%, respectively. Conclusion 3D-PCASL parameters CBFmax, rCBF had certain efficacy in preoperative predicting IDH1 genotyping of gliomas. The stabilities of IVIM parameters were not good, and their value needed to be further studied.
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