磁共振表观弥散系数及其比值鉴别高低级别胶质瘤的价值

The value of magnetic resonance apparent diffusion coefficients and ratios in identifying high and low grade gliomas

目的:探讨磁共振表观弥散系数(ADC)及其比值鉴别高级别胶质瘤(HGG)与低级别胶质瘤(LGG)的价值。方法:回顾性收集2017年3月—2022年10月于梅州市人民医院接受MRI检查的94例胶质瘤患者。在肿瘤实质区、瘤周水肿区及对侧正常脑组织选取感兴趣区(ROI)测量ADC值,并计算肿瘤/正常实质区ADC、肿瘤/瘤周水肿区ADC的比值。比较各指标在HGG与LGG组之间的差异性。将差异有统计学意义的指标纳入Logistic回归分析筛选出独立危险因素,并绘制受试者工作特征(ROC)曲线,评价其鉴别HGG与LGG的诊断效能。结果:HGG与LGG患者的平均年龄、性别比例、肿瘤实质区ADC值、肿瘤/正常脑实质区ADC比值、肿瘤/瘤周水肿区ADC比值差异均具有统计学意义(P <0.05)。Logistic回归分析显示,肿瘤/瘤周水肿区ADC比值和年龄为预测HGG的独立危险因素。根据ROC曲线分析,肿瘤/瘤周水肿区ADC比值、年龄、肿瘤/瘤周水肿区ADC比值联合年龄鉴别HGG与LGG的ROC曲线下面积(AUC)分别为0.881、0.811、0.908,其中肿瘤/瘤周水肿区ADC比值联合年龄的AUC最高。结论:肿瘤/瘤周水肿区ADC比值对鉴别高、低级别胶质瘤具有较高的诊断效能,联合年龄特征后具有更高的效能。

Objective To investigate the value of magnetic resonance apparent diffusion coefficient(ADC)and its ratio in distinguishing high-grade glioma(HGG)from low-grade glioma(LGG).Methods 94 glioma patients who underwent MRI in Meizhou People's Hospital from March 2017 to October 2022 were retrospectively collected.ADC values were measured in the tumor parenchyma area,peritumoral edema area and contralateral normal brain tissue by selecting the region of interest(ROI),and the ADC ratio of tumor/normal parenchyma area,and ADC ratio of tumor/peritumor edema area were calculated.Compare the differences of each index between HGG and LGG groups.Indicators with statistically significant differences were included in logistic regression analysis to screen out independent risk factors,and receiver operating characteristic(ROC)curves were plotted to evaluate their diagnostic efficacy in distinguishing the HGG and LGG.Results The differences in average age,gender ratio,ADC value of tumor parenchyma area,ADC ratio of tumor/normal brain parenchyma area,and ADC ratio of tumor/peritumor edema area between HGG and LGG groups were statistically significant(P<0.05).Logistic regression analysis showed that the ADC ratio of tumor/peritumor edema area and age were the independent risk factors for predicting HGG.According to ROC curve analysis,the area under the ROC curves(AUCs)of tumor/peritumoral edema zone ADC ratio,age,and tumor/peritumoral edema zone ADC ratio combined with age to identify HGG and LGG were 0.881,0.811,and 0.908,respectively,and the AUC of tumor/peritumoral edema zone ADC ratio combined with age was the highest.Conclusion The ADC ratio of tumor/peritumoral edema area has high diagnostic efficacy in identifying LGG and HGG,and even higher efficacy when combined with age characteristics.