摘要
目的探讨表观扩散系数(apparent diffusion coefficient,ADC)值在较低级别胶质瘤(lower-grade gliomas,LGG)异柠檬酸脱氢酶-1(isocitrate dehydrogenase 1,IDH-1)突变状态和瘤细胞增殖活性中的评估价值。材料与方法回顾性分析经病理证实并测定IDH-1突变状态和Ki-67增殖指数的44例LGG患者病例,其中IDH-1突变型24例,IDH-1野生型20例。在ADC图上测量病灶实质的最小ADC值(ADC_(min))、平均ADC值(ADC_(mean))和对侧镜像正常脑白质的ADC值,计算相对最小ADC值(rADC_(min))和相对平均ADC值(rADC_(mean))。比较LGG IDH-1突变型和IDH-1野生型组间各ADC值间差异,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析各ADC值对IDH-1突变状态的评估效能,并分析其与Ki-67增殖指数间的相关性。结果IDH-1突变型组的ADC_(min)、ADC_(mean)、rADC_(min)和rADC_(mean)值均高于IDH-1野生型组,组间差异具有统计学意义(P均<0.05)。ROC曲线结果显示各参数均能对IDH-1突变型和IDH-1野生型LGG进行有效区分,其中,rADC_(min)鉴别效能最佳,以0.978为最佳截止值,相应的曲线下面积(area under the curve,AUC)、敏感度、特异度、准确度、阳性预测值和阴性预测值分别为0.838、80.00%、83.33%、81.82%、80.00%和83.30%。LGG ADC_(min)、ADC_(mean)、rADC_(min)和rADC_(mean)与Ki-67增殖指数间均呈不同程度的负相关关系(r=-0.552、-0.590、-0.532、-0.579,P均<0.05)。结论ADC值可用于评估LGG IDH-1突变状态,对于肿瘤细胞增殖活性的评估也具有一定的价值。
Objective:To investigate the evaluation value of apparent diffusion coefficient(ADC)value in lower-grade gliomas(LGG)isocitrate dehydrogenase 1(IDH-1)mutation status and tumor cell proliferation activity.Materials and Methods:Forty-four patient cases with LGG were confirmed by pathology,and measured IDH-1 mutation status and the Ki-67 proliferation index was retrospectively analyzed,including 24 cases of IDH-1 mutant-type and 20 cases of IDH-1 wild-type.The minimum ADC value(ADC_(min)),mean ADC value(ADC_(mean))of the lesion parenchyma,and the ADC value of the contralateral mirror normal white matter on the ADC maps were measured,and the relative minimum ADC value(rADC_(min))and relative mean ADC value(rADC_(mean))were calculated.The differences in ADC values between the two groups were compared,and receiver operating characteristic(ROC)curves were drawn to evaluate the differential diagnostic efficacy.The Ki-67 proliferation index of the solid tumor components was also measured to explore its relationship with ADC values.Results:The ADC_(min),ADC_(mean),rADC_(min),and rADC_(mean) values in the IDH-1 mutant-type group were higher than those in the IDH-1 wild-type group,and the differences between the groups were statistically significant(all P<0.05).ROC results show that all parameters can effectively distinguish IDH-1 mutant-type and IDH-1 wild-type LGG.Among them,rADC_(min) has the best discrimination efficiency,and 0.978 is the best cut-off value,with area under the curve(AUC),sensitivity,specificity,accuracy,positive predictive value,and negative predictive value was 0.838,80.00%,83.33%,81.82%,80.00%,and 83.30%,respectively.ADC_(min),ADC_(mean),rADC_(min),rADC_(mean) and Ki-67 proliferation index showed different degrees of negative correlation(r=-0.552,-0.590,-0.532,-0.579,all P<0.05).Conclusions:ADC values can be used to evaluate LGG IDH-1 mutation status,and it also has a certain value for evaluating tumor cell proliferation activity.
作者
刘显旺
柯晓艾
周青
李昇霖
邓娟
薛彩强
黄晓宇
孙秋
周俊林
LIU Xianwang;KE Xiaoai;ZHOU Qing;LI Shenglin;DENG Juan;XUE Caiqiang;HUANG Xiaoyu;SUN Qiu;ZHOU Junlin(Department of Radiology,Lanzhou University Second Hospital,Second Clinical School,Lanzhou University,Key Laboratory of Medical Imaging of Gansu Province,Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence,Lanzhou 730030,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2022年第8期13-18,共6页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金(编号:81772006、82071872)
甘肃省自然科学基金项目(编号:21JR11RA105)
甘肃省医学影像重点实验室开放基金(编号:GSYX202007)。
关键词
脑胶质瘤
较低级别胶质瘤
异柠檬酸脱氢酶
Ki-67增殖指数
磁共振成像
表观扩散系数
brain gliomas
lower-grade gliomas
isocitrate dehydrogenase
Ki-67 proliferation index
magnetic resonance imaging
apparent diffusion coefficient
