| 李昇霖,薛彩强,柯晓艾,邓娟,刘显旺,周俊林.MRI征象及表观弥散系数预测高级别胶质瘤O6-甲基鸟嘌呤DNA甲基转移酶启动子甲基化[J].中国医学影像技术,2021,37(4):491~496 |
| MRI征象及表观弥散系数预测高级别胶质瘤O6-甲基鸟嘌呤DNA甲基转移酶启动子甲基化 |
| MRI features and apparent diffusion coefficient in prediction of O6-methylguanine DNA methyltransferase promoter methylation in high-grade gliomas |
| 投稿时间：2020-03-29 修订日期：2021-03-01 |
| DOI：10.13929/j.issn.1003-3289.2021.04.003 |
| 中文关键词: 胶质瘤 磁共振成像 O6-甲基鸟嘌呤DNA甲基转移酶 启动子甲基化 |
| 英文关键词:glioma magnetic resonance imaging O6-methylguanine DNA methyltransferase promoter methylation |
| 基金项目:国家自然科学基金面上项目（81772006、82071872）。 |
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| 中文摘要: |
| 目的 观察术前根据MRI征象及表观弥散系数（ADC）预测高级别胶质瘤（HGG）O6-甲基鸟嘌呤DNA甲基转移酶（MGMT）启动子甲基化状态的价值。方法 回顾性分析85例经病理证实HGG患者术前头部MRI，71例各扫描序列图像完整、14例未接受弥散加权成像；其中58例MGMT启动子甲基化（+）、27例（-）。比较MGMT启动子不同甲基化状态下HGG的MRI定性指标（肿瘤部位、坏死/囊变、出血、瘤脑界面、强化程度）和定量指标[肿瘤最大径、水肿最大径、囊变最大径、最大ADC值（ADCMax）、平均ADC值（ADCMean）、最小ADC值（ADCMin）及相对ADC值（rADC）]的差异；绘制差异有统计学意义的定量指标预测HGG MGMT启动子甲基化的受试者工作特征（ROC）曲线，分析其诊断效能。结果 MGMT启动子甲基化（+）HGG瘤脑界面多模糊（39/58，P<0.05）；左侧颞叶HGG更易出现MGMT启动子甲基化（15/24，P<0.05）；不同MGMT启动子甲基化状态HGG其余MRI定性指标差异均无统计学意义（P均>0.05）。MGMT启动子甲基化HGG的ADCMin、ADCMean及rADC[（0.98±0.25）s/mm2、（1.06±0.24）s/mm2、1.39±0.31]均高于启动子甲基化（-）者[（0.84±0.18）s/mm2、（0.92±0.18）s/mm2、1.19±0.30，P均<0.05]。ADCMin截断值取0.88 s/mm2时，其预测MGMT启动子甲基化的敏感度和特异度分别为76.00%和71.40%；ADCMean截断值取0.98 s/mm2时，敏感度和特异度分别为72.00%和71.40%；rADC截断值取1.24时，敏感度和特异度分别为74.00%和71.40%。结论 术前MRI征象及ADC对于评价HGG MGMT启动子甲基化有一定价值。 |
| 英文摘要: |
| Objective To investigate the value of preoperative MRI features and apparent diffusion coefficient (ADC) for predicting the promoter methylation status of O6-methylguanine DNA methyltransferase (MGMT) in high-grade gliomas (HGG). Methods Preoperative head MRI data of 85 HGG patients confirmed by pathology were retrospectively analyzed, 71 cases having complete MR sequence images and 14 cases without diffusion-weighted imaging. Among 85 cases, there were 58 MGMT promoter methylation (+) and 27 MGMT promoter methylation (-). MRI qualitative indicators, i.e. tumor location, necrosis/cystic change, hemorrhage, tumor-brain interface and degree of enhancement, as well as quantitative indicators including maximum diameter of tumor, maximum diameter of edema, maximum diameter of cyst, the maximum ADC value (ADCMax), average ADC value (ADCMean), the minimum ADC value (ADCMin) and relative ADC value (rADC) were compared between MGMT promoter methylation (+) and (-) HGG. The receiver operating characteristic (ROC) curves were drawn for parameters being statistically different for predicting the promoter methylation of HGG MGMT, respectively, and the corresponding diagnostic efficacy was observed. Results MGMT promoter methylation (+) HGG were more likely to have blurred tumor-brain interface (39/58,P<0.05), and left temporal lobe HGG were prone to be MGMT promoter methylation(+) (15/24, P<0.05). There was no statistical difference of other MRI qualitative indicators of HGG with different MGMT promoter methylation status (all P>0.05). ADCMin, ADCMean and rADC of MGMT promoter methylated (+) HGG ([0.98±0.25]s/mm2,[1.06±0.24]s/mm2, 1.39±0.31) were higher than those of (-)ones ([0.84±0.18] s/mm2,[0.92±0.18]s/mm2,[1.19±0.30]s/mm2, all P<0.05). Taken 0.88 s/mm2 as the cut-off values of ADCMin, the sensitivity and specificity for predicting MGMT promoter methylation were 76.00% and 71.40%; 0.98 s/mm2 as the cut-off values of ADCMean, the sensitivity and specificity were 72.00% and 71.40%; 1.24 as the cut-off values of rADC, the sensitivity and specificity were 74.00% and 71.40%. Conclusion Preoperative MRI features and ADC values had certain value for predicting MGMT promoter methylation status of HGG. |
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