多模态功能MRI评估脑胶质瘤IDH1突变状态的研究

The Research of Multimodal Functional MRI in the Evaluation of IDH1 mutation Status of Glioma

目的:探讨多模态功能MRI在异柠檬酸脱氢酶1(IDH1)突变型或野生型脑胶质瘤诊断中的价值。方法:分析经病理确诊的46例脑胶质瘤患者术前多模态功能MRI影像学特征,分析IDH1突变型组和IDH1野生型组胶质瘤相对表观弥散系数(rADC)值、最小表观弥散系数(ADCmin)值、标准化表观弥散系数(nADC)值、相对脑血流量(rCBF)值、标准化脑血流量(nCBF)值、相对各向异性分数(rFA)值、瘤周纤维束状态及肿瘤内磁敏感信号(ITSS)等级的差异。结果:IDH1突变型组胶质瘤nADC值高于IDH1野生型组,nCBF值低于IDH1野生型组,IDH1突变型组胶质瘤出现3级ITSS比例低于IDH1野生型组,差异均有统计学意义(均P<0.05)。IDH1野生型与突变型组肿瘤间rADC值、ADCmin值、rCBF值、rFA值及瘤周纤维束状态差异均无统计学意义(P=0.090、0.765、0.678、0.067、0.464)。结论:多模态功能MRI影像学特征与脑胶质瘤IDH1基因型有关,且可成为评价IDH1基因型的标志。

Purpose:To observe the value of multimodal functional MRI in the evaluation of glioma isocitrate dehydrogenase(IDH)l mutation status.Methods:Forty-six patients with glioma were divided into IDH1-mutant group and IDH1-wildtype group,and their imaging characteristics were analyzed,including relative apparent diffusion coefficient(rADC)value,minimum apparent diffusion coefficient(ADCmin)value,normalized apparent diffusion coefficient(nADC)value,relative cerebral blood flow(rCBF)value,normalized cerebral blood flow(nCBF)value,relative fractional anisotropy(rFA)value,peritumoral fiber bundle status and the level of intratumoral susceptibility signal(ITSS).Results:Compared with IDH1-wildtype group,the IDH1-mutant group was with higher nADC value(P<0.05)and lower nCBF value(P<0.05),and less likely showed level 3 ITSS with statistically significant difference(P<0.05).There were no statistically significant differences in rADC value,ADCmin value,rCBF value,rFA value and peritumoral fiber bundle status between the two groups(P=0.090,0.765,0.678,0.067,0.464).Conclusion:Multimodal functional MRI imaging characteristics were associated with gliomas IDH1 genotype,and the imaging features could be used as a marker to assess IDH1 genotype.