多参数MRI在诊断脑胶质瘤中的价值及其与Ki-67的相关性分析

Multi-parameter magnetic resonance imaging in the diagnosis of glioma and its correlation with Ki-67

目的:探讨多参数MRI在诊断脑胶质瘤中的价值及其与Ki-67的相关性。方法:搜集经手术病理证实的31例脑胶质瘤患者,根据2016年WHO中枢神经系统肿瘤分类及分级标准分为高级别组(Ⅲ~Ⅳ级)18例,低级别组(Ⅰ~Ⅱ级)13例。所有患者均行颅脑MRI平扫、增强MRI、DWI、多体素磁共振波谱(MRS)及扩散张量成像(DTI)检查。测量病变部位的ADC值、DCavg值、FA值、Cho/Cr值及Cho/NAA值,并进行统计学分析。结果:ADC值、Cho/Cr值、Cho/NAA值及Ki-67指数在高、低级别胶质瘤中差异有统计学意义(P<0.05),DCavg值及FA值差异无统计学意义(P>0.05)。Ki-67与ADC值呈负相关(r=-0.442,P<0.05),与Cho/Cr值、Cho/NAA值呈正相关(r=0.596,r=0.448,P<0.05),而与DCavg值(r=-0.101,P=0.589)及FA值(r=0.147,P=0.429)无相关性。结论:多参数MRI不但有助于脑胶质瘤的术前分级诊断,还可评估肿瘤细胞的增殖活性,具有重要的临床应用价值。

Objective：To explore the value of multi-parameter magnetic resonance imaging in the diagnosis of glioma and its correlation with Ki-67. Methods：31 patients with glioma proved by surgery and pathology were analyzed retrospectively. According to the classification and grading standard of tumors of the central nervous system （CNS） （WHO 2016 version）, 18 cases were rated as high-grade gliomas （ III-IV grade） and 13 cases were identified as low-grade gliomas （I - II grade）. All the patients had cerebral pre-contrast MRI images （Ax T1WI/T2 WI/FLAIR T2WI/DWI/Sag T1WI）, enhaneed-MRI images,multi-voxel MRS and DTI. Post-processing was carried out in the workstation and ADC value,DCavg value, FA value, Cho/Cr and Cho/NAA ratio of lesions were acquired. Results： There was statistical significant difference in ADC value,Cho/Cr ratio,Cho/NAA ratio and Ki-67 index between high-grade and low-grade gliomas （P 〈 0.05）. There was no statistical significant difference in both DCavg value and FA value （P 〉 0.05）. Ki-67 index showed a negative correlation with ADC value （r =-0. 442,P 〈 0. 05） ;however,Ki-67 showed a positive correlation with Cho/Cr and Cho/NAA value, respectively （r =0. 596 and r = 0. 448, respectively, P 〈 0.05）. There was no correlation between Ki-67 index and DCavg and FA value, respectively （r =-0. 101, P ： 0. 589, and r = 0. 147, P = 0. 429, respectively）. Condusion： Multi-parameter magnetic resonance imaging can not only help to preoperatively grade glioma,but also evaluate tumor cell proliferative activity,it has more important clinical value.