3.0T MR扩散张量成像在胶质瘤分级中的临床诊断价值

To Evaluate the Value of 3.0 MR Diffusion Tensor Imaging in Cerebral Glioma Grading

目的探讨MR扩散张量成像在胶质瘤分级中的研究价值。方法 31例胶质瘤患者行3.0T MR常规及扩散张量成像(DTI)检查,定量测量各向异性系数FA及表观弥散系数值(ADC),对低级别、高级别胶质瘤组间定量参数的比较采用Mann-Whitney U检验。以肿瘤ROI中ADC与FA值作为临界点绘制出ROC曲线,计算曲线下面积,确定诊断阈值,评价其诊断效能。结果 14例低级别胶质瘤的FA值为(139.4±81.3);ADC值为(1.36±0.21)×10-3mm2/s;17例高级别胶质瘤FA值为(103.1±41.5),ADC值为(1.09±0.28)×10-3mm2/s.;2两组间参数差异有统计学意义(P<0.05)。以ADC值作为临界点判断肿瘤低高级并绘制ROC曲线,曲线下面积为0.79。以ADC值等于1.11×10-3mm2/s作为诊断阈值,区分低高级肿瘤的敏感度为58.8%,特异度为92.9%。以FA值作为临界点判断肿瘤低高级并绘制ROC曲线,曲线下面积为0.62。以FA值等于178.9作为诊断阈值,区分低高级肿瘤的敏感度为94.1%,特异度为35.7%。结论 DTI中FA值及ADC值对胶质瘤病理分级有重要的评估价值。

Objective To evaluate the value of diffusion tensor cerebral glioma grading at 3.0T. Methods Thirty-one patients confirmed cerebral glioma underwent DTI measurement. The values of FA of tumor tissues were measured and were correlated to the grade of cerebral gliomas by Kruskal- Wallis H test. ROC analysis was used to assess the FA and ADC to distinguish between low-grade glioma （LGG） and high grade glioma （HGG）. Results The FA values were （139.4±81,3） and （103.1 ± 41.5） for LGG） and HGG, respectively. The ADC values were （1.36 ± 0.21）×10^-3mm^2/s and （1.09 ± 0.28）×10^-3mm^2/s for LGG and HGG, respectively. Statistical significance of FA and ADC values were found between LGG and HGG （P〈0.05）. Area under curve （AUC） of ADC/FA was 0.79/0.62, the sensitivity was 58.8%/94.1% and the specificity, was 92.9%/35.7%, with a threshold value of 1.11×10^-3（mm^2）/178.9. Conclusion The DTI parameter-FA and ADC have the potential clinical importance for cerebral glioma grading.