[1]邢士军　王　莉　张丽君.IVIM-MRI对人脑胶质瘤的病理分级及IDH1基因突变的评估价值[J].中国临床神经外科杂志,2020,(12):821-824.[doi:10.13798/j.issn.1009-153X.2020.12.002]
　XING Shi-jun,WANG Li,ZHANG Li-jun..Value of IVIM-MRI in evaluation of pathological grade and IDH1 gene mutation of human glioma[J].,2020,(12):821-824.[doi:10.13798/j.issn.1009-153X.2020.12.002]
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IVIM-MRI对人脑胶质瘤的病理分级及IDH1基因突变的评估价值()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年12期
页码:
821-824
栏目:
论著
出版日期:
2020-12-25

文章信息/Info

Title:
Value of IVIM-MRI in evaluation of pathological grade and IDH1 gene mutation of human glioma
文章编号:
1009-153X（2020）12-0821-04
作者:
邢士军　王　莉　张丽君
213003 江苏常州，苏州大学附属第三医院神经外科（邢士军、王　莉、王丽君）
Author(s):
XING Shi-jun;  WANG Li;  ZHANG Li-jun.
Department of Neurosurgery, The Third Affiliated Hospital of Soochow University (Changzhou First People’s Hospital), Changzhou 213003, China
关键词:
胶质瘤; 体素不相干运动扩散加权磁共振成像; 术前评估; 异柠檬酸盐脱氢酶1
Keywords:
Human glioma;  Intravoxel incoherent motion magnetic resonance imaging;  IVIM-MRI;  Preopertive evaluation
分类号:
R 739.41; R 445.2
DOI:
10.13798/j.issn.1009-153X.2020.12.002
文献标志码:
A
摘要:
目的 探讨体素不相干运动扩散加权（IVIM）-MRI对人脑胶质瘤的病理分级及异柠檬酸盐脱氢酶1（IDH1）突变的评估价值。方法 回顾性分析2016年1月至2019年12月术后病理确诊的100例脑胶质瘤的临床资料。术前应用3.0 T MRI扫描仪检查，获取IVIM-MRI参数，包括灌注比例系数（F）、真实扩散系数（D）、伪扩散系数（D*）与表观扩散系数（ADC）。结果 与高级别胶质瘤相比，低级别胶质瘤ADC值与D值明显增高（P<0.05），而F值与D*值均显著降低（P<0.05）。无论是低级别胶质瘤，还是高级别胶质瘤，IDH1基因突变型病人ADC值显著高于IDH1基因突野生型（P<0.05）。高级别胶质瘤病人中，IDH1基因突变型病人F值、D*值均显著低于IDH1基因野生型（P<0.05）。ROC曲线分析显示，对于鉴别胶质瘤级别，ADC值的最佳临界值为1.091，灵敏度为86.92%，特异度为89.45%；D值的最佳临界值为0.934，灵敏度为78.26%，特异度为94.71%；D*值的最佳临界值为6.161，灵敏度为73.95%，特异度为73.66%；F值的最佳临界值为0.190，灵敏度为56.55%，特异度为100.00%。对于区分IDH1基因型，低级别胶质瘤病人中，ADC值区分IDH1基因突变的最佳临界值为1.181，灵敏度为92.87%，特异度为80.01%；高级别胶质瘤病人中，F值的效能最高，灵敏度为100.00%，特异度为92.87%。结论 IVIM-MRI定量分析可用于胶质瘤术前诊断与分级，并对预测胶质瘤IDH1基因状态具有潜在意义。
Abstract:
Objective To investigate the predictive value of intravoxel incoherent motion (IVIM)-MRI in the evaluation of pathological grade and IDH1 gene mutation of human glioma. Methods A retrospective analysis on the clinical data of 100 patients with glioma diagnosed by postoperative pathological examination from January 2016 to December 2019 was performed. All the patients received IVIM-MRI examination preoperatively using 3.0 T MRI scanner to obtain IVIM-MRI parameters, including perfusion scale coefficient (F), true diffusion coefficient (D), pseudo diffusion coefficient (D*) and apparent diffusion coefficient (ADC). Results The ADC and D values of the low-grade glioma tissues were significantly higher than those of the high-grade glioma tissues (P<0.05), while the F and D* values ??were significantly lower than those of the high-grade glioma tissues (P<0.05) . The ADC values of the low-grade glioma and high-grade glioma tissues with IDH1 gene mutation were significantly higher than those without IDH1 gene mutation (P<0.05). Of high-grade glioma tissues, the F value and D* values of IDH1 gene mutant glioma tissues were significantly lower than those without IDH1 gene mutation (P<0.05). ROC curve analysis showed that, for distinguishing high-grade and low-grade gliomas, the best cut-off value of ADC value was 1.091, with a sensitivity of 86.92% and a specificity of 89.45%; the best cut-off value of the D value was 0.934, with a sensitivity of 78.26% and a specificity of 94.71%; the best cut-off value of the D* value was 6.161, with a sensitivity of 73.95% and a specificity of 73.66%; the best cut-off value of the F value was 0.190, with a sensitivity of 56.55% and a specificity of 100.00%; for distinguishing IDH1 gene mutation in low-grade gliomas, the best cut-off value of the ADC value was 1.181, with a sensitivity of 92.87% and a specificity of 80.01%; for distinguishing IDH1 gene mutation in high-grade gliomas, the F value had the highest efficiency, with a sensitivity of 100.00% and a specificity of 92.87%. Conclusion IVIM-MRI can be used for preoperative diagnosis and grading of gliomas and has potential significance in predicting the IDH1 gene mutation status of gliomas.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81302197）
更新日期/Last Update: 2020-12-25