Mills S J, Patankar T A, Haroon H A, Balériaux D, Swindell R, Jackson A
Department of Imaging Science and Biomedical Engineering, Christie Hospital NHS Trust, Manchester, United Kingdom.
AJNR Am J Neuroradiol. 2006 Apr;27(4):853-8.
Noninvasive measurements of cerebral blood volume (CBV) and contrast transfer coefficient (K(trans)) have potential benefits in the diagnosis and therapeutic management of adult glioma. This study examines the relationship between CBV, K(trans), and overall survival.
Twenty-seven adult patients with glioma underwent T1-weighted dynamic contrast-enhanced MR imaging, and parametric maps of CBV and K(trans) were calculated. The relationship of histologic grade, CBV, K(trans), age, sex, surgical resection, and use of adjuvant therapy to survival were analyzed by using the logrank method and Cox regression analysis. The Kaplan-Meier method for displaying survival curves was used. The relationship of factors such as comorbidity, elevated intracranial pressure, size of nonenhancing tumor, and peritumoral edema were not considered.
Both CBV (P < .01) and K(trans) (P < .01) show a significant relationship to histologic grade. CBV (P = .004), K(trans) (P = .008), and histologic grade (P < .001) all demonstrate a significant association with patient survival when analyzed individually. Cox regression analysis identified only histologic grade (P < .01) and K(trans) (P < .05) as independent significant prognostic indicators. Examination of survival data from high-grade (III and IV) tumors demonstrated a linear relationship between K(trans) and patient survival (P < .01).
This study suggests a direct relationship between K(trans) and length of survival in high-grade gliomas, which could be of clinical importance. CBV relates directly to histologic grade but provides no independent prognostic information over and above that provided by grade. Further large prospective studies should be planned to test whether this observation holds true.
脑血容量（CBV）和对比剂转移系数（K(trans)）的无创测量在成人胶质瘤的诊断和治疗管理中具有潜在益处。本研究探讨了CBV、K(trans)与总生存期之间的关系。
27例成年胶质瘤患者接受了T1加权动态对比增强磁共振成像，并计算了CBV和K(trans)的参数图。采用对数秩检验法和Cox回归分析，分析组织学分级、CBV、K(trans)、年龄、性别、手术切除及辅助治疗的使用与生存期的关系。采用Kaplan-Meier法绘制生存曲线。未考虑合并症、颅内压升高、无强化肿瘤大小及瘤周水肿等因素的关系。
CBV（P <.01）和K(trans)（P <.01）均与组织学分级显著相关。单独分析时，CBV（P =.004）、K(trans)（P =.008）和组织学分级（P <.001）均与患者生存期显著相关。Cox回归分析仅确定组织学分级（P <.01）和K(trans)（P <.05）为独立的显著预后指标。对高级别（III级和IV级）肿瘤的生存数据进行分析，结果显示K(trans)与患者生存期呈线性关系（P <.01）。
本研究表明，高级别胶质瘤中K(trans)与生存期长短直接相关，这可能具有临床重要性。CBV与组织学分级直接相关，但除分级所提供的信息外，未提供独立的预后信息。应计划进一步开展大型前瞻性研究，以验证这一观察结果是否成立。
