肿瘤最小ADC值在胶质瘤分级中的应用研究

Diagnostic Value of Minimum Apparent Diffusion Coefficient in Grading of Gliomas

目的:评价肿瘤最小ADC值在胶质瘤分级中的应用价值。方法:回顾性分析81例经病理证实的胶质瘤患者常规MRI及DWI资料,其中低级别胶质瘤31例(Ⅰ级3例、Ⅱ级28例),高级别胶质瘤50例(Ⅲ级21例、Ⅳ级29例)。在ADC图上测量肿瘤组织最小ADC值。统计学方法应用成组t检验、单因素方差分析以及Spearman相关性分析。结果:低级别胶质瘤平均最小ADC值[(1.279±0.270)×10-3mm2/s]高于高级别胶质瘤平均最小ADC值[(0.849±0.185)×10-3mm2/s](P<0.001),高于Ⅲ级胶质瘤平均最小ADC值[(0.92±0.201)×10-3mm2/s](P<0.001),也高于Ⅳ级胶质瘤平均最小ADC值[(0.797±0.156)×10-3mm2/s](P<0.001),但Ⅲ级与Ⅳ级胶质瘤平均最小ADC值无统计学差异(P=0.069)。肿瘤最小ADC值与胶质瘤级别呈显著负相关(r=-0.699,P<0.001)。结论:肿瘤最小ADC值有助于胶质瘤分级诊断。

Purpose： To assess the utility of the minimum apparent diffusion coefficient （minADC） for grading gliomas. Methods： Findings from 81 patients with pathologically proven gliomas that included 31 low grade gliomas （LGG） （grade I： 3; grade II： 28） and 50 high grade gliomas （HGG） （grade III： 21; grade IV： 29） were analyzed retrospectively. The minADC value of each tumor was determined from several regions of interest defined in the tumor on ADC maps correlation analysis were used for statistical evaluation Student t test, one-way ANOVA and Spearman Results： The mean value of minADC for LGGs [（1.279 ± 0.270）×10-3mm2/s] was higher than that of HGGs [（0.849 ± 0.185） ×10-3mm2/s] （P〈0.001）. The mean value of minADC showed significant differences between LGG, grade Ill [（0.92±0.201）×10-3mm2/s] and grade IV [（0.797±0.156）×10-3mm2/s] tumors （P〈0.001）. But there was no significant difference between the mean value of minADC of grade III and that of grade IV tumors （P=0.069）. There was significant negative correlation between minADC and different tumor grades （r=-0.699, P〈0.001）. Conclusion： The minADC is useful for prediction of glioma grade.