磁共振成像结合扩散加权成像在脑神经胶质瘤分级诊断中的应用

Application of magnetic resonance imaging and diffusion weighted imaging in the grading diagnosis of cerebral glioma

目的分析核磁共振成像(MRI)结合扩散加权成像(DWI)在脑神经胶质瘤分级诊断中的应用。方法选择2018年5月至2020年3月洛阳新区人民医院收治的脑神经胶质瘤患者58例作为研究对象,根据世界卫生组织(WHO)分级标准,其中高分级37例,低分级21例;所有患者均行头颅MRI结合DWI检查,且经手术病理诊断确诊。分析MRI平扫、增强与DWI对脑神经胶质瘤分级诊断的一致性;比较2组表观扩散系数(ADC),并绘制受试者工作特征(ROC)曲线,评价ADC值对脑神经胶质瘤分级的诊断效能。结果MRI平扫、增强与DWI对脑神经胶质瘤分级诊断中,MRI结合DWI诊断一致性最高(Kappa=0.889,P<0.01)。高分级组ADC值低于低分级组,差异有统计学意义(P<0.05);ADC值对脑神经胶质瘤分级诊断的曲线下面积(AUC)为0.853,最佳阈值为0.930×10-3mm2/s,敏感度为0.905,特异度为0.568。结论MRI结合DWI诊断脑神经胶质瘤分级与病理结果比较,具有较高一致性,且ADC值对鉴别高分级与低分级具有重要价值,可为临床诊疗提供依据。

Objective To analyze the application of magnetic resonance imaging(MRI)combined with diffusion weighted imaging(DWI)in the grading diagnosis of cerebral glioma.Methods 58 patients with cere-bral glioma,treated in our hospital from May 2018 to March 2020,were selected as research subjects.Accor-ding to the World Health Organization classification standards,37 cases were high grade,and 21 cases were low grade.All patients received a combined cranial MRI and DWI(MRI+DWI)examination,and the diagnosis was confirmed through surgical pathological diagnosis.We analyzed the consistency of plain MRI,enhanced scanning,and DWI in the grading diagnosis of glioma.Furthermore,we compared the apparent diffusion coeffi-cients(ADCs)of the two groups and generated a receiver operating characteristic curve to evaluate the diagn-ostic efficacy of the ADC for the grading of cerebral glioma.Results Cranial MRI+DWI had the highest con-sistency in the diagnosis of cerebral gliomas using plain scanning,enhanced MRI,and DWI(Kappa=0.889,P<0.001).The ADC of the high-grade group was lower than that of the low-grade group,and their difference was statistically significant(P<0.05).The ADC for the grading diagnosis of cerebral glioma was 0.853,while the optimal threshold was 0.930×10-3 mm2/s,sensitivity was 0.905,and specificity was 0.568.Conclusion Compared with the pathological results,the MRI+DWI diagnosis of glioma has a higher consistency and the ADC is very useful for distinguishing high-grade cases from low-grade cases,which can provide a basis for clinical diagnosis andtreatment.