多模态MRI检查对脑胶质瘤患者病理分级的诊断价值及术后复发的预测价值

Diagnostic value of multimodal MRI examination for pathological grading of glioma patients and the predictive value of postoperative recurrence

目的探讨多模态MRI检查对脑胶质瘤患者病理分级的诊断价值及术后复发的预测价值。方法选取160例脑胶质瘤患者,以病理检查结果为金标准,评估多模态MRI检查对脑胶质瘤患者病理分级的诊断价值,其诊断脑胶质瘤患者病理分级的结果与病理检查结果的一致性采用Kappa检验。比较高级别与低级别脑胶质瘤患者多模态MRI检查参数[相对表观弥散系数(rADC)、相对各向异性值(rFA)、胆碱(Cho)/肌酐(Cr)]。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估多模态MRI检查参数对脑胶质瘤患者术后复发的预测价值。结果病理结果显示,低级别脑胶质瘤73例,高级别脑胶质瘤87例,多模态MRI检查诊断脑胶质瘤病理分级的符合率为86.88%(139/160),其与病理检查结果的一致性较高(Kappa=0.818)。高级别脑胶质瘤患者Cho/Cr明显高于低级别脑胶质瘤患者,rADC、rFA均明显低于低级别脑胶质瘤患者,差异均有统计学意义(P﹤0.01)。ROC曲线显示,多模态MRI检查参数rADC、rFA、Cho/Cr预测脑胶质瘤患者术后复发的AUC分别为0.820、0.873、0.853,均具有一定的预测价值。结论多模态MRI检查对脑胶质瘤患者病理分级的诊断价值及术后复发的预测价值均较高,其参数rADC、rFA、Cho/Cr对脑胶质瘤患者的术后复发均具有一定的预测价值。

Objective To explore diagnostic value of multimodal MRI examination for pathological grading of glioma patients and the predictive value of postoperative recurrence.Method A total of 160 patients with glioma were selected,the pathological examination results was used as the gold standard,the diagnostic value of multimodal MRI examination for pathological grading of glioma patients was evaluated.The consistency between the pathological grading of glioma patients by multimodal MRI examination and the pathological examination results was determined by Kappa test.The multimodal MRI examination parameters[relative apparent diffusion coefficient(rADC),relative fractional anisotropy(rFA),choline(Cho)/creatinine(Cr)]were compared between high-grade and low-grade glioma patients.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of multimodal MRI examination parameters in postoperative recurrence of glioma patients was evaluated.Result The pathological results showed that there were 73 cases of low-grade glioma and 87 cases of high-grade glioma.The diagnostic accuracy of multimodal MRI examination for pathological grading of glioma was 86.88%(139/160),which showed a high consistency with the pathological examination results(Kappa=0.818).The Cho/Cr in patients with high-grade glioma was significantly higher than that in patients with low-grade glioma,while rADC and rFA were significantly lower than those in patients with low-grade glioma,and the differences were statistically significant(P<0.01).The ROC curve showed that the AUC of the multimodal MRI examination parameters rADC,rFA,and Cho/Cr in predicting postoperative recurrence of glioma patients were 0.820,0.873,and 0.853,respectively,all of which had certain predictive value.Conclusion The diagnostic value of multimodal MRI examination for pathological grading of glioma patients and the predictive value for postoperative recurrence are both high.Its parameters rADC,rFA,Cho/Cr have certain predictive value for postoperative recurrence of glioma patients.