磁共振弥散加权成像信号强度定量测定对脑胶质瘤术前分级临床意义

The guiding significance of quantitative measurement of magnetic resonance diffusion weighted imaging signal for preoperative grading brainglioma

目的探讨磁共振弥散加权成像(DWI)信号强度定量测定对脑胶质瘤(BG)术前分级。方法选择2016年5月-2017年10月收治手术治疗BG患者30例作为研究对象,所有患者在术前进行常规、增强磁共振(MRI)扫描及多b值DWI检查,工作站处理软件获得相应的弥散系数(ADC)、分布扩散系数(DDC)、拉伸因子(α)等值,并绘制ROC曲线。结果 12例低级别GB患者实质部分其ADC、DDC及α值显著高于18例高级别GB组(P<0.05),经过与对侧镜像脑实质对比标准化后,以上数据差异仍有统计学意义;Pearson相关性检验结果显示,ADC和DDC之间存在正相关,其在高级别BG中相关系数r=0.826(P<0.05),低级别BG中相关系数为0.926(P<0.05);ADC、DDC及α值3个定量指标均可对BG分级具有较高的诊断价值,其中ADC曲线下面积(AUG)为0.952,显著大于α(0.838)与DDC(0.852)(P<0.05),DDC和α其AUG差异无统计学意义(P>0.05)。敏感度最高的是ADC(100%),特异度最好的是DDC(86.7%)。结论术前DWI信号测量的ADC、DDC和α值均可作为BG术前分级诊断的指标,且拉伸指数模型更加优于传统的单指数模型。

Objective To explore the significance of quantitative measurement of magnetic resonance diffusion weighted imaging(DWI)for preoperative grading and treatment of brain glioma(BG).Method in our hospital from May 2016 to 2017 year in October in our hospital for surgical treatment of BG patients with a total of 30 cases as the research object,all patients in the preoperative routine and contrast-enhanced magnetic resonance scanning and multiple test b value of DWI resonance imaging workstation,software obtained the corresponding diffusion coefficient(ADC),the distribution of diffusion coefficient(DDC),elongation factor(alpha)equivalent,and ROC curve.Results 12 cases of patients with low grade BG,DDC and ADC part of the essence of alpha value was significantly higher than that in 18 cases of high grade BG group(P<0.05),the difference was statistically significant,after contralateral brain parenchyma compared to the standard after the above data is still statistically significant;Pearson correlation test results show that the existence of positive correlation between ADC and DDC,the high grade BG coefficient r=0.826(P<0.05),low grade BG correlation coefficient was 0.926(P<0.05);ADC,DDC and alpha value of diagnostic value of 3 quantitative indicators are higher in the classification of BG,the area under the ADC curve(AUG)was 0.952,significantly higher than alpha(0.838)and DDC(0.852)(P<0.05),no significant difference between DDC and alpha AUG(P>0.05).The highest sensitivity is ADC(100%),and the best specificity is DDC(86.7%).Conclusion By quantifying the intensity of magnetic resonance DWI in BG,ADC,DDC and alpha values can be used as indicators of preoperative grading diagnosis of glioma,and the stretch index model may be better than the traditional single index DWI.