摘要
目的:探究儿童不同分子亚型的髓母细胞瘤(medulloblastoma,MB)磁共振成像(magnetic resonance imaging,MRI)特征差异。方法:回顾并分析经手术后病理学检查证实的55例MB,按分子亚型将其分为4组。各组患儿均在术前1周内行MRI平扫、增强MRI及弥散加权成像(diffusion-weighted imaging,DWI)检查,比较分析病灶MRI的基本征象,同时分析各分子亚型测得的表观弥散系数(apparent diffusion coefficient,ADC),包括最大ADC值(ADCmax)、最小ADC值(ADCmin)、平均ADC值(ADCmean)及rADC(ADC1mean/ADC2mean)的差异性。结果:肿瘤好发位置、增强表现方式、瘤周水肿、最大径及ADCmax差异有统计学意义(P<0.05)。其中100.0%的Group 3型和86.4%的Group 4型位于中线区,而41.1%的WNT型位于小脑半球,P=0.010;肿瘤强化表现方式上,Group 4型中27.3%呈轻微或无强化特点,而绝大多数的SHH型(76.5%)及Group 3型(88.9%)呈明显强化方式,P=0.004;同样,SHH型常伴轻度或明显瘤周水肿,而Group 3型和Group 4型常无或轻微的瘤周水肿,P=0.024;最大径显示WNT型通常比其他亚型小;ADCmax、ADCmean、ADCmin及rADC,只有ADCmax差异有统计学意义(P<0.05),WNT型ADCmax最大,为(1.181±0.572)×10^(-3)mm^(2)/s,SHH型最小,为(0.678±0.094)×10^(-3)mm^(2)/s。结论:肿瘤位置及增强表现方式对儿童MB分子亚型的预测有重要价值,而肿瘤的瘤周水肿、最大径有一定的辅助价值,ADCmax价值尚有争议。
Objective:To explore the differences in magnetic resonance imaging(MRI)features of children with different molecular subtypes of medulloblastoma(MB).Methods:A retrospective analysis of 55 cases of MB confirmed by surgery wascarriecl,and patients were divided into four groups according to molecular subtypes.Children in each group underwent MRI plain scan,enhancement MRI and diffusion-weighted imaging(DWI)within one week before surgery.The basic signs of MRI of the lesion were compared and analyzed,and the apparent diffusion coefficient(ADC)measured of each molecular subtype,including the maximum ADC(ADCmax),the minimum ADC(ADCmin),and the average ADC(ADCmean)and rADC(ADC1mean/ADC2mean)wrer analyzed.Results:There were statistically significant differences in tumor location,enhancement manifestation,peritumoral edema,maximum diameter and ADCmax(P<0.05).Among them,100.0%of Group 3 and 86.4%of Group 4 were located in the midline area,while 41.1%of WNT were located in the cerebellar hemisphere,P=0.010.In terms of tumor enhancement manifestation,27.3%of Group 4 had mild or no enhancement,and the vast majority of SHH(76.5%)and Group 3(88.9%)showed obvious enhancement,P=0.004;similarly,SHH often accompanied by mild or obvious peritumoral edema,while Group 3 and Group 4 often accompanied by absent or mild peritumoral edema,P=0.024;the largest diameter showed that WNT was usually smaller than other subtypes;and ADCmax,ADCmean,ADCmin and rADC were compared,only ADCmax had statistical difference(P<0.05).WNT ADCmax was the largest,which was(1.181±0.572)×10^(-3)mm^(2)/s,and SHH was the smallest,which was(0.678±0.094)×10^(-3)mm^(2)/s.Conclusion:Tumor location and enhanced manifestation are of great value in predicting the molecular subtypes of MB in children.The peritumoral edema and maximum diameter of the tumor have certain auxiliary value.The value of ADCmax is still controversial.
作者
赵江
郑慧
张征委
金彪
ZHAO Jiang;ZHENG Hui;ZHANG Zhengwei;JIN Biao(Department of Radiology,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)
出处
《肿瘤影像学》
2021年第3期195-203,共9页
Oncoradiology
基金
上海市卫生健康委员会科研课题(20204Y0164)。
关键词
髓母细胞瘤
分子亚型
磁共振成像
弥散加权成像
Medulloblastoma
Molecular subtype
Magnetic resonance imaging
Diffusion-weighted imaging
