| 王俊丽,范淼,初建平,赵静,许顺良.动态对比增强MRI灌注参数和ADC值在儿童脑胶质瘤病理分级中的应用[J].中国医学影像技术,2015,31(5):678~682 |
| 动态对比增强MRI灌注参数和ADC值在儿童脑胶质瘤病理分级中的应用 |
| Application of parameters of dynamic contrast-enhanced MRI and ADC in grading pediatric gliomas |
| 投稿时间：2014-12-17 修订日期：2015-03-22 |
| DOI：10.13929/j.1003-3289.2015.05.010 |
| 中文关键词: 儿童 胶质瘤 扩散磁共振成像 灌注成像 表观扩散系数 |
| 英文关键词:Child Glioma Diffusion magnetic resonance imaging Perfusion imaging Apparent diffusion coefficient |
| 基金项目:国家自然科学基金青年基金项目(81201074)、中央高校基本科研业务费(中山大学青年教师培育计划,13ykpy14)。 |
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| 中文摘要: |
| 目的 探讨动态对比增强磁共振成像(DCE-MRI)灌注参数[血管渗透性常数(Ktrans)、细胞外血管外间隙容量(ve)、速率常数(kep)和相对强化率的曲线下面积(iAUC)]和ADC值在儿童脑胶质瘤病理分级中的价值。方法 回顾性分析经手术病理或穿刺活检证实脑胶质瘤患儿16例,均行颅脑DCE-MRI和DWI。其中低级别胶质瘤(Ⅰ、Ⅱ级)11例、高级别胶质瘤(Ⅲ、Ⅳ级)5例。记录肿瘤实质区各ROI的灌注参数(Ktrans、ve、kep、iAUC)和ADC值。对灌注参数和ADC值行双样本t检验和ROC曲线分析。结果 Ktrans、ve、kep、iAUC和ADC值对鉴别儿童高、低级别胶质瘤的差异均有统计学意义(P均<0.01),ROC曲线下面积分别为0.77、0.83、0.89、0.77、0.85(P均<0.01)。Ktrans、ve、kep、iAUC、ADC对儿童脑胶质瘤术前分级诊断的敏感度分别为100%、100%、95%、100%、81%,特异度分别为63%、69%、70%、63%、83%。Ktrans、ve、kep、iAUC和ADC值鉴别高、低级别胶质瘤的界点分别为0.06/min、0.15、0.87/min、3.20、1.04×10-3 mm2/s。结论 DCE-MRI灌注参数和ADC值均可用于儿童脑胶质瘤的病理分级,其中DCE-MRI灌注参数的敏感度较高,ADC值的特异度较高。 |
| 英文摘要: |
| Objective To explore value of parameters (transfer constant [Ktrans], extravascular extracellular space fractional volume [ve], rate constant of backflux [kep], iAUC) of dynamic contrast-enhanced MR (DCE-MRI) and ADC in grading pediatric gliomas. Methods Sixteen children with gliomas confirmed by histopathology underwent DCE-MRI and DWI. Eleven cases were low-grade gliomas (Ⅰand Ⅱgrade), five cases were high-grade gliomas (Ⅲ and Ⅳgrade). The perfusion parameters (Ktrans, ve, kep, iAUC) and ADC of gliomas were recorded, which were analyzed by two sample t-test and ROC curves analysis. Results There were significant differences between the low and high grade gliomas in the Ktrans, ve, kep, iAUC and ADC (all P<0.01), and the area under ROC curve were 0.77, 0.83, 0.89, 0.77, and 0.85, respectively (all P<0.01). The sensitivity of Ktrans, ve, kep, iAUC, ADC were 100%, 100%, 95%, 100%, 81%, and the specificity were 63%, 69%, 63%, 70%, 63%, 83%, respectively. Threshold value of Ktrans, ve, kep, iAUC and ADC in determining low and high grade gliomas were 0.06/min, 0.15, 0.87/min, 3.20, 1.04×10-3 mm2/s, respectively. Conclusion Both DCE-MRI perfusion parameters and ADC can be used to determine pathology grading of pediatric gliomas. The sensitivity of DCE-MRI perfusion parameters are higher than that of ADC, however the specificity of ADC higher than that of perfusion parameters. |
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