DTI在不同级别胶质瘤术前分级中的应用价值

Application of Magnetic Resonance Diffusion Tensor Imaging in Preoperative Grading of Cerebral Gliomas

目的:评价磁共振扩散张量成像(DTI)FAmax值、ADCmin值、r FAmax值及r ADCmin值在不同级别胶质瘤术前分级中的应用价值。方法:收集我院经神经外科手术病理证实的胶质瘤患者共84例(其中I级胶质瘤9例,II级胶质瘤16例,III级胶质瘤22例,IV级胶质瘤37例),分为低级别组25例,高级别组59例。所有病例术前均行常规磁共振成像扫描(T1WI、T2WI、三平面TIWI增强)及扩散张量成像扫描。通过测量肿瘤实质区的FAmax值、ADCmin值及对侧"正常"脑白质的平均FA及ADC,计算出r FAmax值及r ADCmin值,并对结果进行统计学分析,判断其对胶质瘤术前分级的价值。结果:低级别胶质瘤肿瘤实质区FAmax值(0.334±0.074)、r FAmax值(0.475±0.087)均低于高级别胶质瘤的FAmax值(0.451±0.071)、r FAmax值(0.668±0.116),差异有统计学意义(P<0.05);低级别胶质瘤肿瘤实质区的ADCmin值(0.789±0.058)、r ADCmin值(1.075±0.083)高于高级别胶质瘤的ADCmin值(0.687±0.065)、r ADCmin值(0.912±0.089),差异有统计学意义(P<0.05)。结论:DTI的FAmax、ADCmin值的测量可以区分高、低级别胶质瘤,在高、低级别胶质瘤术前分级中有较高的应用价值,可将其作为胶质瘤患者术前的常规扫描序列。

Objective:To evaluate the value of magnetic resonance diffusion tensor imaging FAmax,ADCmin,r FAmax and r ADCmin in preoperative grading of different grades of glioma.Methods:A total of 84 patients with glioma confirmed by neurosurgery pathology in our hospital were collected(including 9 patients with grade I glioma,16 patients with grade II glioma,22 patients with grade III glioma,and 37 patients with grade IV glioma),which were divided into 25 patients in the low-grade group and 59 patients in the high-grade group.All patients underwent conventional magnetic resonance imaging(T1WI,T2WI,triplane TIWI enhancement)and diffusion tensor imaging before operation.The r FAmax value and the r ADCmin value were calculated by measuring the FAmax value,the ADCmin value,and the mean FA and ADC of the contralateral"normal"white matter,and the results were statistically analyzed to determine the value of glioma preoperative grading.Results:The FAmax values(0.334±0.074)and r FAmax values(0.475±0.087)in the parenchymal areas of low-grade glioma tumors were less than the FAmax values(0.451±0.071)and rFAmax values(0.668±0.116)of high-grade gliomas(P<0.05).The ADCmin values(0.789±0.058)and rADCmin values(1.075±0.083)in the parenchymal region of low-grade glioma tumors were greater than those of high-grade gliomas(0.687±0.065)and rADCmin(0.912±0.089)P<0.05).After spearman correlation test,FAmax value and ADCmin value showed a significant negative correlation(r=-0.83,P<0.01).Conclusion:The FAmax and ADCmin values of DTI have high application value in preoperative grading of high and low grade glioma,and there is a significant negative correlation between the two,which can be used as the routine preoperative scanning sequence of glioma patients.