多发胶质瘤高影像异质性表现的多模态MRI研究

Multimodal MRI Study on the High Imaging Heterogeneity of Multiple Gliomas

目的采用多模态MRI技术,并结合直方图分析方法,观察多发胶质瘤相比单发胶质瘤肿瘤异质性的差异。方法回顾性纳入东部战区总医院2013年1月至2018年4月有完整术前MRI检查资料并经手术或活检病理证实的多发脑胶质瘤患者48例,并从医院数据库随机挑选年龄、性别及采集时间段相匹配的单发脑胶质瘤48例。采用直方图分析方法,对T1WI平扫及增强、T2WI、DWI多模态MRI数据进行分析,计算肿瘤瘤体内的直方图分析参数。采用两样本t检验进行组间比较,并选取多发胶质瘤中有统计学差异的直方图参数与病理指标Ki-67进行相关分析。结果相比单发胶质瘤患者,多发胶质瘤在T2WI的峰度值及偏度值、平均扩散系数(ADC)的平均值、第25百分位数、中位数等指标较具有统计学差异(P<0.05),并发现多发胶质瘤ADC直方图参数第25百分位数与Ki-67呈负相关。结论相比单发脑胶质瘤,多发脑胶质瘤有更高的肿瘤异质性,且异质性与肿瘤生物学行为相关。

Objective To observe the difference in tumor heterogeneity between multiple gliomas and single gliomas using multi-modality MRI technology combined with histogram analysis.Methods We retrospectively included 48 patients with multiple gliomas who had preoperative MRI examination from January 2013 to April 2018 and were confirmed by surgery or biopsy pathology,and randomly selected age and gender.Forty-eight cases of single gliomas with matching time periods were also collected.The histogram analysis method was used to analyze the T1WI plain and enhanced scan,T2WI,DWI(ADC)multimodal MRI data,and calculate the histogram analysis parameters of the tumor.The two-sample t-test was used to compare between groups.The histogram parameters with statistical differences in gliomas were correlated with the pathological index Ki-67.Results Compared with patients with single gliomas,the peak value(kv)and skewness value(sv),mean value of ADC(mean),25 th quartile(Q1),median and kurtosis values(kv)of multiple gliomas on T2WI were statistically different(P<0.05),and the ADC histogram parameter Q1 of multiple gliomas was found to be negatively correlated with Ki67.Conclusion Compared with single glioma,multiple gliomas have higher tumor heterogeneity,and the heterogeneity is related to tumor biological behavior.