胶质瘤中扩散张量成像、动态磁敏感对比增强磁共振成像及（99m）锝-替曲膦脑单光子发射计算机断层扫描与肿瘤分级及Ki-67免疫组化的相关性
Correlation of diffusion tensor, dynamic susceptibility contrast MRI and (99m)Tc-Tetrofosmin brain SPECT with tumour grade and Ki-67 immunohistochemistry in glioma.
作者信息
Alexiou George A, Zikou Anastasia, Tsiouris Spyridon, Goussia Anna, Kosta Paraskevi, Papadopoulos Athanasios, Voulgaris Spyridon, Kyritsis Athanasios P, Fotopoulos Andreas D, Argyropoulou Maria I
机构信息
Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece.
Department of Radiology, University Hospital of Ioannina, Ioannina, Greece.
出版信息
Clin Neurol Neurosurg. 2014 Jan;116:41-5. doi: 10.1016/j.clineuro.2013.11.003. Epub 2013 Nov 16.
OBJECTIVE
Assessment of the grade and type of glioma is of paramount importance for prognosis. Tumour proliferative potentials may provide additional information on the behaviour of the tumour, its response to treatment and prognosis. The purpose of this study was to investigate the correlation between diffusion tensor imaging (DTI), dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) and (99m)Tc-Tetrofosmin brain single-photon emission computed tomography (SPECT), and the tumour grade and Ki-67 labelling index in newly diagnosed gliomas.
METHODS
Study was made of patients with suspected glioma on brain MRI between December 2010 and January 2012, by DTI, DSC MRI and (99m)Tc-Tetrofosmin brain SPECT. The proliferative activity of each tumour was measured by deriving the Ki-67 proliferation index from immunohistochemical staining of tumour specimens.
RESULTS
Glioma was newly diagnosed in 25 patients (17 men, 8 women, aged 19-79 years, median 55 years). The Ki-67 index ranged from 1% to 80% (mean 19.4%). On evaluation of the relationship between the (99m)Tc-Tetrofosmin tumour uptake by gliomas was found to be significantly correlated with cellular proliferation (rho=0.924, p<0.0001). Regarding DTI, significant negative correlation was demonstrated between the apparent diffusion coefficient (ADC) ratio and the Ki-67 index (rho=-0.545, p=0.0087). Significant correlation was also observed between the fractional anisotropy (FA) ratio and the Ki-67 index (rho=0.489, p=0.02). Strong correlation was found between relative cerebral blood volume (rCBV) and Ki-67 index (rho=0.853, p<0.0001), and between the (99m)Tc-Tetrofosmin lesion-to-normal (L/N) uptake ratio and rCBV (rho=0.808, p ≤ 0.0001). Significant negative correlation was demonstrated between the (99m)Tc-Tetrofosmin L/N ratio and ADC ratio (rho=-0.513, p=0.014). These imaging techniques were able to distinguish between low-grade and high-grade gliomas.
CONCLUSIONS
Findings on DSC MRI and brain SPECT with (99m)Tc-Tetrofosmin metrics were more closely correlated with glioma cellular proliferation.
目的
评估胶质瘤的分级和类型对预后至关重要。肿瘤增殖潜能可能为肿瘤行为、其对治疗的反应及预后提供额外信息。本研究的目的是探讨弥散张量成像（DTI）、动态磁敏感对比增强（DSC）磁共振成像（MRI）和（99m）锝-替曲膦脑单光子发射计算机断层扫描（SPECT）与新诊断胶质瘤的肿瘤分级及Ki-67标记指数之间的相关性。
方法
对2010年12月至2012年1月间脑MRI怀疑患有胶质瘤的患者进行研究，采用DTI、DSC MRI和（99m）锝-替曲膦脑SPECT检查。通过对肿瘤标本进行免疫组织化学染色得出Ki-67增殖指数，来测量每个肿瘤的增殖活性。
结果
新诊断出25例胶质瘤患者（17例男性，8例女性，年龄19 - 79岁，中位年龄55岁）。Ki-67指数范围为1%至80%（平均19.4%）。评估发现，胶质瘤对（99m）锝-替曲膦的摄取与细胞增殖显著相关（rho = 0.924，p < 0.0001）。关于DTI，表观扩散系数（ADC）比值与Ki-67指数之间存在显著负相关（rho = -0.545，p = 0.0087）。各向异性分数（FA）比值与Ki-67指数之间也观察到显著相关性（rho = 0.489，p = 0.02）。相对脑血容量（rCBV）与Ki-67指数之间存在强相关性（rho = 0.853，p < 0.0001），（99m）锝-替曲膦病变与正常组织（L/N）摄取比值与rCBV之间也存在强相关性（rho = 0.808，p ≤ 0.0001）。（99m）锝-替曲膦L/N比值与ADC比值之间存在显著负相关（rho = -0.513，p = 0.014）。这些成像技术能够区分低级别和高级别胶质瘤。
结论
DSC MRI和采用（99m）锝-替曲膦指标的脑SPECT检查结果与胶质瘤细胞增殖的相关性更强。
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