DWI和最小ADC值对少突胶质细胞肿瘤分级诊断的价值

The Value of DWI and Minimum ADC Value in Grading Diagnosis of Oligodendrocyte Tumors

目的探讨DWI和最小ADC值对不同级别少突胶质细胞肿瘤(OG)分级诊断的价值。方法回顾性分析经手术病理证实的18例少突胶质细胞瘤(OD,WHOⅡ级)与27例间变性少突胶质细胞瘤(AOG,WHOⅢ级)的临床、病理资料及DWI特征,测量肿瘤实质部分的最小ADC值,进行两者之间差异性的比较,并绘制受试者工作特征(ROC)曲线评价最小ADC值的分级诊断价值。结果18例OD中,肿瘤实性部分在DWI上有14例呈稍高/高信号,2例呈等/低信号,2例呈不均匀混杂信号,最小ADC值为(0.798±0.159)×10-3mm2/s;27例AOG中,肿瘤实性部分在DWI上有19例呈稍高/高信号,2例呈等/低信号,6例呈不均匀混杂信号,最小ADC值为(0.670±0.108)×10-3mm2/s,两种级别OG实质部分的最小ADC值存在统计学意义(t=3.223,P<0.05)。ROC曲线结果显示:AUC值为0.761,以最小ADC值0.734×10-3mm2/s作为两者分级诊断的阈值时,分级诊断的敏感性及特异性分别为72%、74%。结论DWI和最小ADC值可用于OG的分级诊断,以提高术前诊断准确率。

Objective To investigate the value of DWI and minimum ADC value in the diagnosis of different grades of oligodendroglial tumors(OG).Methods A retrospective analysis of 18 cases of oligodendroglioma(OD,WHO classⅡ)and 27 cases of anaplastic oligodendroglioma(AOG,WHO classⅢ)confirmed by surgery and pathology.Clinical,pathological data and DWI characteristics,the minimum ADC value of the tumor parenchyma were measured and the difference between the two was compared,and the receiver operating characteristic curve(ROC curve)was drawn to evaluate the minimum ADC value in grading.Results Of the 18 cases of oligodendroglioma,14 of the solid parts of the tumor showed slightly higher/high signal on DWI,2 showed equal/low signal,2 showed heterogeneous mixed signal,and the minimum ADC value was(0.798±0.159)×10-3mm2/s;in 27 cases of anaplastic oligodendroglioma,19 of the solid part of the tumor showed slightly higher/high signal on DWI,2 showed equal/low signal,and 6 showed no heterogeneous mixed signal,the minimum ADC value was(0.670±0.108)×10-3mm2/s,and the difference in the minimum ADC value between the two groups was statistically significant(t=3.223,P<0.05).The ROC curve results showed that the AUC value was 0.761,and the minimum ADC values of the parenchymal fraction of the two grades of oligodendrocyte tumors were statistically significant(t=3.223,P<0.05).The AUC of ROC curve was of 0.761,when the minimum ADC value is 0.734×10-3mm2/s as the threshold for the grading diagnosis,the sensitivity and specificity of the grading diagnosis were 72%and 74%,respectively.Conclusion DWI and minimum ADC value can be used in the grading diagnosis of oligodendroglial tumors and improve the accuracy of preoperative diagnosis.