磁共振在评估胶质母细胞瘤IDH1突变状态中的价值

MRI evaluation of IDH1 mutation status in glioblastoma multiforme

目的分析对比胶质母细胞瘤IDH1野生型和IDH1突变型的MRI影像学特征。方法选取资料完整并经手术病理证实的60例胶质母细胞瘤患者的MRI影像资料,其中IDH1野生型21例,IDH1突变型39例,除4例IDH1突变型未行DWI检查外,所有病例均行T_1WI、T_2WI、FLAIR及DWI等常规序列扫描,并行T_1WI增强扫描。观察肿瘤发病年龄、性别、部位、最大面积、最大囊变坏死面积、囊变坏死面积比、平均表观扩散系数(ADC)等指标并行统计分析。结果IDH1野生型好发于左侧额叶,IDH1突变型最好发于右侧额叶,两组间有统计学意义;IDH1野生型最大面积、最大囊变坏死面积均高于IDH1突变型,两组间有统计学意义;IDH1野生型发病年龄较突变型年轻;两组间发病性别、囊变坏死面积比无统计学意义;IDH1野生型ADC值(0.894±0.102)×10^(-3 )mm^2/s,IDH1突变型ADC值(0.907±0.036)×10^(-3 )mm^2/s,两组间差异无统计学意义。结论MRI可初步评估胶质母细胞瘤的IDH1突变状态,从而指导临床治疗方案的精确设计和预后评估。

Objective To study MRI features of IDH1wild and mutation types of glioblastoma multiforme(GBM).Methods MRI of60patients with histologically confirmed GBMs including IDH1wild type(21)and IDH1mutation type(39)was retrospectively analyzed.Apart from4IDH1mutation type GBMs without diffusion-weighted MR imaging(DWI),all patients underwent pre-operative T1-,T2-,FLAIR-weighted MRI and DWI as well as contrast-enhanced T1-weighted imaging.The age and gender of patients,location,maximum area and ratio of necrosis and mean apparent diffusion coefficient(ADC)of tumors were statistically analyzed.Results IDH1wild type was more common in the left frontal lobe and IDH1mutation type more frequently occurred in the right frontal lobe.IDH1mutation type involved younger patients with significantly smaller tumor and less necrosis than IDH1wild type.There was no significant difference in patient gender,necrosis ratio and ADCs between the two types.Conclusion IDH1mutation type of GBM involved younger patients with significantly smaller tumor and less necrosis than IDH1wild type on MRI.