瘤周水肿区扩散张量成像定量参数在胶质瘤分级中的诊断价值

Diffusion Tensor Imaging Quantitative Parameters in the Diagnosis of Peritumoral Edema Area in the Glioma Grading

目的探讨胶质瘤瘤周水肿区近、中、远不同区域扩散张量成像(DTI)中相对各向异性分数(rFA)值及相对表观扩散系数(rADC)值鉴别诊断胶质瘤分级的价值。资料与方法回顾性分析经病理证实的48例胶质瘤患者的DTI资料,其中高级别组30例,低级别组18例。取轴位水肿径线最大层面,测量瘤周水肿区近、中、远不同区域FA值和ADC值及对侧半球镜像正常白质区的FA值和ADC值,然后计算瘤周水肿区不同区域rFA值(rFA1、rFA2、rFA3)和rADC值(rADC1、rADC2、rADC3),比较其变化情况及在高、低级别胶质瘤中的差异。结果高级别组胶质瘤瘤周水肿区rFA1、rFA2、rFA3低于低级别组,差异有统计学意义(P<0.05);高级别组胶质瘤瘤周水肿区rADC1、rADC2、rADC3高于低级别组,差异有统计学意义(P<0.05)。ROC曲线分析显示,rFA1、rFA2、rFA3、rADC1、rADC2和rADC3鉴别高、低级别胶质瘤的曲线下面积分别为0.972、0.893、0.854、0.743、0.761、0.694,rFA1与rFA2、rFA3的ROC曲线下面积差异有统计学意义(P<0.05),rFA2与rFA3的ROC曲线下面积差异无统计学意义(P>0.05);rADC1、rADC2和rADC3的ROC曲线下面积两两比较,差异无统计学意义(P>0.05);rFA1或rFA2与rADC1、rADC2、rADC3的ROC曲线下面积差异有统计学意义(P<0.05);rFA3与rADC1、rADC2的ROC曲线下面积差异无统计学意义(P>0.05)。结论瘤周水肿区近、中、远不同区域DTI定量参数rFA值和rADC值鉴别诊断胶质瘤高、低级别均有一定的价值,但rFA值的诊断效能明显优于rADC值。

Purpose To investigate the value of relative fractional anisotropy（rFA）and relative apparent diffusion coefficient（rADC）in diffusion tensor imaging（DTI）of different regions of glioma around the near,middle and distal regions in its high and low level identification.Materials and MethodsThe DTI data of 48 patients（30 cases of high grade,and 18 cases of low grade）with gliomas confirmed by pathology were analyzed retrospectively.Taking the axis of the largest level of edema line,the value of FA and ADC of the peritumoral edema in near,middle and far regions from the tumors and the FA value as well as ADC value of the normal white matter region of the contralateral hemisphere mirror were measured.The rFA values（rFA1,rFA2,rFA3）and rADC values（rADC1,rADC2,rADC3）in different regions of the peritumoral edema area were calculated,their changes and differences in high and low-grade gliomas were analyzed.ResultsThe rFA1,rFA2 and rFA3 in the edema area of the high-grade group were lower than those of the low-grade group（P〈0.05）.The rADC1,rADC2 and rADC3 in the edema area of the high-grade group were higher than those of the low-grade group（P〈0.05）.ROC analysis showed the area under the curveof rFA1,rFA2,rFA3,rADC1,rADC2 and rADC3 were 0.972,0.893,0.854,0.743,0.761 and 0.694,respectively.There were significantly statistical differences between rFA1 and rFA2,and between rFA1 and rFA3（P〈0.05）,while there was no difference between rFA2 and rFA3（P〈0.05）.There was no significantly statistical difference between rADC1,rADC2 and rADC3（P〈0.05）.There was statistically significant difference between rFA1 or rFA2 and rADC1,rADC2,rADC3（P〈0.05）.There was no difference between rFA3 and rADC1,rADC2（P〈0.05）.ConclusionIn the near,middle and far regions of peritumoral edema area,quantitative parameters of DTI,rFA value and rADC value in the differential diagnosis of gliomas have a certain value,but the diagnostic efficiency of rFA value is significantly better than that of rADC.