摘要
目的探讨3D-Slicer软件在脑膜瘤患者发生术后瘤周水肿(PTBE)加重评估中的应用价值。方法回顾性选取2020年10月至2022年6月于郑州大学第二附属医院神经外科接受手术治疗的脑膜瘤患者129例,将发生术后PTBE加重的患者作为术后PTBE加重组(n=37),其余患者作为无术后PTBE加重组(n=92)。比较两组年龄、性别、术前水肿指数(EI)、肿瘤体积、Ki-67、术中引流静脉受损情况、肿瘤良恶性情况、癫痫发作情况。采用多因素Logistic回归分析探讨脑膜瘤患者发生术后PTBE加重的影响因素。采用ROC曲线评估术前EI和肿瘤体积对脑膜瘤患者发生术后PTBE加重的预测价值。结果术后PTBE加重组术前EI低于无术后PTBE加重组,肿瘤体积大于无术后PTBE加重组,Ki-67、术中引流静脉受损者占比高于无术后PTBE加重组(P<0.05)。多因素Logistic回归分析结果显示,术前EI升高、肿瘤体积增大、Ki-67升高是脑膜瘤患者发生术后PTBE加重的危险因素,术中引流静脉未受损是脑膜瘤患者发生术后PTBE加重的保护因素(P<0.05)。ROC曲线分析结果显示,术前EI及肿瘤体积预测脑膜瘤患者发生术后PTBE加重的AUC分别为0.83〔95%CI(0.77,0.90)〕、0.80〔95%CI(0.73,0.88)〕,最佳截断值分别为123%、24.5 cm^(3),灵敏度分别为83.8%、75.7%,特异度分别为73.9%、65.2%。结论术前EI升高、肿瘤体积增大、Ki-67升高是脑膜瘤患者发生术后PTBE加重的危险因素,而术中引流静脉未受损是脑膜瘤患者发生术后PTBE加重的保护因素,且术前EI及肿瘤体积对脑膜瘤患者发生术后PTBE加重有较好的预测价值。未来可借助3D-Slicer软件评估脑膜瘤患者术前EI及肿瘤体积以预测术后PTBE加重发生风险,进而对患者进行个体化干预。
Objective To investigate the application value of 3D-Slicer software in the evaluation of postoperative peritumoral brain edema(PTBE)aggravation in patients with meningioma.Methods A total of 129 patients with meningioma who received surgical treatment in the Department of Neurosurgery,the Second Affiliated Hospital of Zhengzhou University from October 2020 to June 2022 were retrospectively selected.Patients with postoperative PTBE aggravation were classified as postoperative PTBE aggravation group(n=37),and the others were classified as no postoperative PTBE aggravation group(n=92).Age,gender,preoperative edema index(EI),tumor volume,Ki-67,intraoperative drainage vein damage,benign and malignant tumor,and epileptic seizure were compared between the two groups.Multivariate Logistic regression analysis was used to investigate the influencing factors of postoperative PTBE aggravation in patients with meningioma.ROC curve was used to evaluate the predictive value of preoperative EI and tumor volume for postoperative PTBE aggravation in patients with meningioma.Results The preoperative EI of postoperative PTBE aggravation group was lower than that of no postoperative PTBE aggravation group,tumor volume was lager than that of no postoperative PTBE aggravation group,Ki-67 and the proportion of patients with intraoperative drainage vein damage were higher than those of no postoperative PTBE aggravation group(P<0.05).The results of multivariate Logistic regression analysis showed that increased preoperative EI,tumor volume and Ki-67 were risk factors for postoperative PTBE aggravation in patients with meningioma,and no intraoperative drainage vein damage was protective factor for postoperative PTBE aggravation in patients with meningioma(P<0.05).ROC curve analysis results showed that the AUC of preoperative EI and tumor volume for predicting postoperative PTBE aggravation in meningioma patients was 0.83[95%CI(0.77,0.90)]and 0.80[95%CI(0.73,0.88)],the optimal cut-off value was 123%and 24.5 cm^(3),the sensitivity was 83.8%
作者
张恒
陶胜忠
刘展
马帅
ZHANG Heng;TAO Shengzhong;LIU Zhan;MA Shuai(Department of Neurosurgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《实用心脑肺血管病杂志》
2023年第3期59-62,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
2020年河南省医学教育研究项目(Wjlx2020086)。
关键词
脑膜瘤
术后瘤周水肿
水肿指数
三维重建
3D-Slicer
Meningioma
Postoperative peritumoral brain edema
Edema index
Three-dimensional reconstruction
3D-Slicer
