DSC-PWI与脑胶质瘤分级及Ki-67表达应用研究

Application of DSC-PWI in Grading and Ki-67 Expression of Glioma

目的 探究DSC-PWI与高、低级别胶质瘤以及Ki-67抗原表达差异性与相关性。方法 选取我院于2019年12月至2020年12月病理确诊为脑胶质瘤且有Ki-67表达指数检测患者,采用Philips 3.0T MR扫描及后处理工作站分析,观察其灌注参数值与脑胶质瘤分级及Ki-67表达的关系及检验效能。结果 总共35例患者,12例低级别胶质瘤,23例高级别胶质瘤。两组的rCBF、rCBV及Ki-67指数具有显著统计学差异(P<0.01)和正相关(P<0.01)。ROC分析显示,rCBF、rCBV对鉴别低、高级别胶质瘤和Ki-67表达程度均有一定预测价值,且rCBF=2.33、rCBV=2.10为鉴别低、高级别胶质瘤的临界值,rCBF=2.33、rCBV=2.16为判断Ki-67表达高低的临界值。两者rCBV值诊断效能均优于rCBF值。结论 DSC-PWI技术对初步评估脑胶质瘤分级以及Ki-67表达有重要意义。

Objective To explore the difference and correlation of DSC-PWI between high-grade and low-grade gliomas and Ki-67 expression in tumors. Methods We selected patients who were pathologically diagnosed as glioma and had Ki-67 expression index testing as the research objects in our hospital from December 2019 to December 2020. In this study,Philips 3.0T MR scanning and postprocessing workstation were used to analyze the DSC-PWI sequence and to observe the relationship between the perfusion parameter value and the glioma grade,as well as the Ki-67 expression and the efficiency of test. Results A total of 35 patients were selected. 12 patients were low-grade gliomas and 23 patients were high-grade gliomas. Two groups had significant statistical difference(P<0.01) and positive correlation(P<0.01). ROC analysis showed that r CBF and r CBV have certain predictive value in differentiating low-grade and high-grade gliomas and Ki-67 expression. In this study,r CBF=2.33,r CBV=2.10 were the cut-off value for distinguishing low-grade and high-grade gliomas while r CBF=2.33,r CBV=2.16 were the cut-off value for judging the expression level of Ki-67. The study also found that r CBV values were better than the r CBF values for the identification of high-grade and low-grade gliomas preoperative classification and the judgment of the expression of Ki-67. Conclusion DSC-PWI technique is of great significance for the preliminary assessment of glioma grade and Ki-67 expression.