NODDI在脑胶质瘤分级中的初步探讨

Preliminary study on NODDI in cerebral glioma staging

目的:回顾性探讨神经突起方向离散度与密度成像(NODDI)参数对胶质瘤分级的诊断价值。方法:高、低级别胶质瘤共29例,男18例、女11例,平均年龄45岁,其中高级别胶质瘤16例,低级别胶质瘤13例。患者术前行常规MRI及高级扩散扫描,经后处理软件得到神经突内体积分数图(ficvf)和神经突方向离散度图(ODI),分别测量肿瘤实性区域(TP)、瘤周水肿区域(PT)和对侧正常参照区域的ficvf_(mean)、ficvf_(min)、ficvf_(max)、ODI_(mean)、ODI_(min)和ODI_(max)值,并通过受试者工作特征(ROC)曲线进行比较分析。结果:低级别胶质瘤和高级别胶质瘤肿瘤实质区ficvf各参数值均较正常对照区低,差异有统计学意义(P<0.05);高级别胶质瘤肿瘤实质区ficvf、ODI值均比低级别胶质瘤肿瘤实质区要高,差异有统计学意义(P<0.05);高级别胶质瘤瘤周水肿区个别ficvf、ODI值比低级别胶质瘤肿瘤实质区要低,差异无统计学意义(P>0.05);独立参数肿瘤实性区ficvf、ODI的ROC曲线下面积(AUC)均大于0.5(P<0.05),其中肿瘤实质区ficvf_(mean)、ficvf_(max)值的AUC均为0.81。结论:NODDI参数ficvf、ODI能鉴别高低级别胶质瘤,其中ficvf值效果更优。

Objective：The purpose of this study was to explore the diagnostic value of neuronaloriented dispersibility and density imaging（NODDI）parameters in glioma grading.Methods：29 patients（13 low-grade gliomas including 9 males and 4 females,with 45-year-old mean age;16 high-grade gliomas including 9 males and 7 females,with 52-year-old mean age）were prospectively recruited undergo whole-brain NODDI examination.Intracellular volume fraction（ficvf）and orientation dispersion index（ODI）maps were derived.ROIs were manually placed on tumor parenchyma（TP）,peritumoral area（PT）and contralateral normal-appearing white matter.The average values of ficvf and ODI were calculated and their diagnostic efficiency was assessed by receiver operating characteristic（ROC）.Results：The ficvf values in the TP area of high-grade gliomas and low-grade gliomas were significantly lower than those in the normal control group（P〈0.05）.The ficvf and ODI values in the TP and PT area of high-grade gliomas were significantly higher than those in low-grade gliomas（P〈0.05）.The area under the ROC curve of ficvf and ODI was greater than 0.5（P〈0.05）,while the area under curve of ficvfmeanand ficvfmax was 0.81.Conclusion：NODDI parameters ficvf and ODI have a good predicting value in gliomas grading,ficvf is better than ODI.