Martínez-Martínez A, Martínez-Bosch J
Sección de Neurorradiología, Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España.
Sección de Neurorradiología, Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen de las Nieves, Granada, España.
Radiologia. 2014 Jan-Feb;56(1):35-43. doi: 10.1016/j.rx.2013.02.006. Epub 2013 Jun 21.
To study the usefulness of common MRI perfusion parameters for identifying pseudoprogression in high grade astrocytomas.
This retrospective case-control study compared the relative cerebral blood volume (rCBV), the relative percentage of signal intensity recovery (rPSR), and the relative peak height (rPH) recorded in a sample of 17 cases of anaplastic astrocytomas and gliomas considered to be undergoing pseudoprogression by biopsy or follow-up with those recorded in a sample of histologically similar tumors that were treated and considered to be undergoing progression by histologic study or follow-up. We evaluated the accuracy of these parameters and the correlations among them. Statistical significance was set at P<.05.
The rCBV, rPSR, and rPH were significantly different between the two groups (P=.001). The cutoff values rPH=1.37, rCBV=0.9, and rPSR=99% yielded sensitivity (S)=88% and specificity (Sp)=82.2% for rPH, S=100% and Sp=100% for rCBV, and S=100% and Sp=70.6% for rPSR, respectively. We found negative correlations between rPRS and rPH (-0.76) and between rPRS and rCBV (-0.81) and a high positive correlation between rPH and rCBV (0.87).
The variables rPH and rCBV were useful for differentiating between pseudoprogression and true progression in our sample. The variable rPRS was also very sensitive, although the overlap in the values between samples make it less useful a priori.
研究常见MRI灌注参数在识别高级别星形细胞瘤假性进展中的作用。
这项回顾性病例对照研究比较了17例间变性星形细胞瘤和胶质瘤样本中记录的相对脑血容量（rCBV）、信号强度恢复相对百分比（rPSR）和相对峰高（rPH），这些病例经活检或随访被认为处于假性进展期，将其与组织学相似肿瘤样本中记录的rCBV、rPSR和rPH进行比较，后一组肿瘤经治疗且经组织学研究或随访被认为处于进展期。我们评估了这些参数的准确性及其相互之间的相关性。设定统计学显著性为P<0.05。
两组之间的rCBV、rPSR和rPH存在显著差异（P = 0.001）。截断值rPH = 1.37、rCBV = 0.9和rPSR = 99%时，rPH的灵敏度（S）= 88%，特异度（Sp）= 82.2%；rCBV的S = 100%，Sp = 100%；rPSR的S = 100%，Sp = 70.6%。我们发现rPRS与rPH之间呈负相关（-0.76），rPRS与rCBV之间呈负相关（-0.81），rPH与rCBV之间呈高度正相关（0.87）。
在我们的样本中，rPH和rCBV变量有助于区分假性进展和真性进展。rPRS变量也非常敏感，尽管样本间数值存在重叠，使其先验实用性较低。
