MRI形态学特征以及瘤体、瘤周表观弥散系数预测不同级别胶质瘤IDH-1基因突变的价值研究

The Value of MRI Morphological Characteristics and Intratumoral and Peritumoral Apparent Diffusion Coefficient in Predicting IDH-1 Mutations in Different Grade Gliomas

目的探讨MRI形态学特征以及表观弥散系数(ADC值)预测较低级别胶质瘤(WHO2-3级)、WHO4级高胶质瘤IDH-1突变的价值。方法回顾性收集徐州医科大学附属医院2021年1月至2023年5月经病理确诊的100例胶质瘤患者的临床、病理以及影像检查资料,其中2-3级44例(IDH-1突变型32例,野生型12例)、4级56例(IDH-1突变型10例,野生型46例)。比较测得的ADC相关参数值以及常规MRI形态学特征在不同级别胶质瘤中IDH-1突变型和野生型之间的差异。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价各项指标的预测效能。结果在较低级别胶质瘤中,IDH-1突变型通常无强化或轻度强化,与IDH-1野生型的差异有统计学意义;在较低级别和WHO4级胶质瘤中,IDH-1突变型与IDH-1野生型的tADCmean、tADCmin、rADCt/C均存在显著差异,分别以tADCmin、tADCmean对IDH-1突变的预测效能最高,曲线下面积为0.759、0.763。瘤周ADC参数在两组间均无统计学差异。结论MRI形态学特征以及表观弥散系数对预测胶质瘤的IDH-1基因突变有一定价值。

Objective To investigate the value of MRI morphological characteristics and apparent diffusion coefficient(ADC value)in predicting IDH-1 mutations in low-grade gliomas(WHO2-3 grade)and WHO4-grade high gliomas.Methods The clinical,pathological and imaging data of 100 patients with pathologically confirmed glioma from January 2021 to May 2023 in the Affiliated Hospital of Xuzhou Medical University were retrospectively collected,including 44 cases of grade 2-3(32 cases of IDH-1 mutant type and 12 cases of wild type)and 56 cases of grade 4(10 cases of IDH-1 mutant type and 46 cases of wild type).Compare the measured ADC-related parameter values and the differences between IDH-1 mutant and wild type in different grades of glioma with conventional MRI morphological features.The receiver operating characteristic(ROC)curve was plotted to evaluate the predictive performance of various indicators.Results In lower-grade gliomas,IDH-1 mutant type was usually unfortified or mildly enhanced,and the difference with IDH-1 wild type was statistically significant.In the lower grade and WHOIV grade glioma,there were significant differences between the tADCmean,tADCmin and rADCt/C of IDH-1 wild type,tADCmin and tADCmean had the highest prediction efficiency for IDH-1 mutation,and the areas under the curve were 0.759 and 0.763,respectively.There were no significant differences in peritumor ADC parameters between the two groups.Conclusion MRI morphological characteristics and apparent diffusion coefficient have certain value in predicting IDH-1 gene mutation in glioma.