摘要
目的探究磁共振体素内不相干运动成像(IVIM)在术前胶质瘤病理分级及预测Ki-67LI表达的价值。方法收集2017年11月至2019年1月经病理证实的胶质瘤30例,低级别组13例,高级别组17例。男性13例,女性17例,平均年龄(47.7±17.5)岁。所有患者均行MRI平扫及IVIM-DWI检查,测量肿瘤最大层面实性区域的真性扩散系数(D值)、微循环灌注系数(D*值)及灌注分数(f值),术后应用免疫组化检查测定Ki-67标记指数(Ki-67LI)。运用SPSS 17.0及Med Calc进行统计学分析,对于所有计量资料两次测量的一致性运用ICC检验;高、低级别组胶质瘤的D值,f值及D*值的比较采用独立样本t检验及Mann-Whitney U非参数秩和检验。Ki-67LI与D值,f值及D*值的相关性运用双变量Spearson相关分析。各参数的诊断效能运用受试者特性曲线(ROC)及其曲线下面积(AUC)进行评价,其中AUC的比较采用Z检验。结果 D、D*及f值两次测量的一致性均较强(ICC>0.80)。D、D*及f值在高低级别胶质瘤组间差异性具有统计学意义(P<0.05),三者的ROC曲线下面积分别为0.928、0.842及0.835(P<0.05),但三者之间AUC比较差异无统计学意义(P>0.05),诊断阈值分别为1.12×10^(-3)mm^(-2)/s、5.68×10^(-2)mm^(-2)/s及38.7%;敏感度分别为82.35%、82.35%、82.24%,特异度分别为92.31%、84.62%、69.23%。IVIM的参数D值与Ki-67LI呈负相关,相关系数为-0.659(P<0.01);D*及f值均与Ki-67LI呈正相关(P<0.01)。结论 D、D*及f值可定量评价胶质瘤术前病理分级及肿瘤细胞增殖活性,进而评估其预后。
Objective To explore the value of Intravoxel voxel incoherent motion imaging in preoperative pathological grading and prediction of Ki-67 LI expression in gliomas.Methods Thirty cases of gliomas proved by pathology were collected.13 cases were divided into low-grade groups and 17 cases into high-grade groups.13 males and 17 females with an average age of(47.7±17.5)years.All patients were examined by MRI and IVIM-DWI.The I VIM datas were processed on a workstation to get D,D*,f values.The Ki-67 labeling indexes were obtained by immunohistochemical detection.SPSS 17.0 and MedCalc were used for statistical analysis.ICC test was used to analyze the consistency of two measurements of all measurement data.The comparison of D value,f value,and D*value between high-and low-grade gliomas was performed by independent sample t-test and Mann-Whitney U nonparametric rank-sum test.The correlations between Ki-67 LI and D value,f value,and D*value were used bivariate Spearson correlation analysis.The diagnostic efficacy of each parameter was evaluated by the ROC(area under the curve,AUC)and diagnostic threshold.Results For D,D*,and f values,the two measurements are consistent with each other(ICC>0.8).The differences of D,D*,and f values between high-and low-grade gliomas were statistically significant(P<0.05).The AUCs of the three parameters were 0.928,0.842,and 0.835(P<0.05),However,the differences among the three AUCs were no significant.The diagnostic thresholds were 1.12×10^(-3)mm^(2)/s,5.68×10^(-2)mm^(2)/s and38.7%,respectively.The sensitivity was 82.35%,82.35%,82.24%,and the specificity 92.31%,84.62%,69.23%,respectively.D value was negatively correlated with Ki-67 LI,the correlation coefficient was-0.659,P<0.01,D*,and f were positively correlated with Ki-67 LI(P<0.01),and the correlation coefficient of f value was higher than that of D*value.Conclusion D,D*and f values can quantitatively evaluate the preoperative pathological grade and tumor cell proliferation activity of gliomas,and then evaluate the prognosis of gliom
作者
冯海霞
安丽华
顾龙
FENG Hai-xia;AN Li-hua;GU Long(Department of Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,Shandong Province,China;Department of Radiology,Jining Hospital of Traditional Chinese Medicine,Jining 272000,Shandong Province,China)
出处
《中国CT和MRI杂志》
2021年第6期26-30,共5页
Chinese Journal of CT and MRI
