脑良恶性胶质瘤实质与瘤周T1、T2值差别的研究

The study of T1 and T2 values in differentiating of benign and malignant gliomas

目的利用多对比度一站式弛豫定量技术(magnetic resonance image complication,Magic)对脑胶质瘤进行术前分级.材料与方法回顾性分析经手术病理证实的胶质瘤22例,高级别胶质瘤(high grade glioma,HGG)13例(59.09%),低级别胶质瘤(low grade glioma,LGG)9例(40.91%),全部病例均使用Magic技术在强化前后扫描;在自动生成的T1 maping、T2 maping测量肿瘤实质和瘤周1 cm范围内的T1值(quantitative T1 values,qT1)、T2值(quantitative T2 values,qT2).结果增强后HGG肿瘤实质qT1为688.44±143.79,LGG为1189.37±592.37,两组间差异显著(P<0.05);增强后T1值变化的百分比HGG为(127±68)%,LGG为(58±63)%,两组间差异显著(P<0.05);肿瘤实质其他测量值和瘤周所有测量值两组间没有显著差别(P>0.05).HGG和LGG实质增强后qT1的ROC曲线下面积为0.786,诊断阈值为927 ms,敏感度为55.6%,特异度为100%;HGG和LGG增强后T1值变化百分比的曲线下面积为0.786,诊断阈值为42.5%,敏感度为92.3%,特异度为55.6%.结论胶质瘤增强后qT1和增强后T1值变化的百分比对HGG和LGG的区分有价值.

Objective:To discuss the value in the classification of cerebral gliomas using magnetic resonance image complication(Magic).Materials and Methods:Twenty-two cases with gliomas confirmed by clinical surgery pathology(13 cases of high grade,9 cases of low grade)were included.All cases were performed with Magic technology before and after enhancement;T1 values(qT1)and T2 values(qT2)within the tumor parenchyma,and peritumoral region(within 1cm around the tumor parenchyma)were measured using automatically generated T1maping and T2 maping images.Receiver operating characteristic analysis(ROC)of T1 value after enhancement and the percentage change of T1 value were performed to evaluate cut-off values between high and low-grade tumors.The sensitivity and specificity were analyzed between high-grade glioma tumor(HGG)and low-grade gliomas(LGG)with independent sample t-test.Results:The pre-contrast T1 and T2 value of the HGG parenchyma were:1478.59±232.92,and 127.41±20.02,and T1 value after enhancement was 688.44±143.79;The percentage change of T1 value was(127±68)%;The pre-contrast T1 and T2 value of the LGG parenchyma were 1610.78±333.87,167.15±61.09,and T1 value after enhancement was 1189.37±592.37;The percentage change of T1 value was(58±63)%.The post-contrast qT1 of HGG parenchyma was less than that of LGG parenchyma,and the percentage change of T1 value of HGG parenchyma was greater than that of LGG parenchyma significantly(P<0.05);there were no significant differences in other measured values between the two groups.the pre-contrast T1 and T2 value of the HGG peritumoral region HGG were 1367.36±213.64 and 162.87±35.56,and T1 value after enhancement was 1334.67±260.85;the percentage change of T1 value was(4±10)%.The pre-contrast T1 and T2 value of the LGG peritumoral region were:1239.00±259.46 and 133.07±48.07,and T1 value after enhancement was 1160.48±286.44;the percentage change of T1 value was(8±9)%.There was no statistical difference between all measured values of peritumoral regions between the HGG and LGG groups(P>0.05).The area under the ROC curve(AUC)of qT1 after enhancement was=0.786,and the diagnostic threshold was 927 ms;the sensitivity was 55.6%,and the specificity was 100%.The AUC of the rate of the percentage change of T1 value was 0.786,and the diagnostic threshold was 42.5%;the sensitivity was 92.3%,and the specificity was 55.6%.Conclusions:The Magic scan sequence may assist in the grading of cerebral gliomas.