动态对比增强磁共振成像衍生的对比剂转移系数和血容量在脑胶质瘤患者中的术前预后价值
Preoperative prognostic value of dynamic contrast-enhanced MRI-derived contrast transfer coefficient and plasma volume in patients with cerebral gliomas.
作者信息
Nguyen T B, Cron G O, Mercier J F, Foottit C, Torres C H, Chakraborty S, Woulfe J, Jansen G H, Caudrelier J M, Sinclair J, Hogan M J, Thornhill R E, Cameron I G
机构信息
From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.)
From the Departments of Diagnostic Imaging (T.B.N., G.O.C., C.H.T., R.E.T., I.G.C., S.C., J.M.C.).
出版信息
AJNR Am J Neuroradiol. 2015 Jan;36(1):63-9. doi: 10.3174/ajnr.A4006. Epub 2014 Jun 19.
BACKGROUND AND PURPOSE
The prognostic value of dynamic contrast-enhanced MR imaging-derived plasma volume obtained in tumor and the contrast transfer coefficient has not been well-established in patients with gliomas. We determined whether plasma volume and contrast transfer coefficient in tumor correlated with survival in patients with gliomas in addition to other factors such as age, type of surgery, preoperative Karnofsky score, contrast enhancement, and histopathologic grade.
MATERIALS AND METHODS
This prospective study included 46 patients with a new pathologically confirmed diagnosis of glioma. The contrast transfer coefficient and plasma volume obtained in tumor maps were calculated directly from the signal-intensity curve without T1 measurements, and values were obtained from multiple small ROIs placed within tumors. Survival curve analysis was performed by dichotomizing patients into groups of high and low contrast transfer coefficient and plasma volume. Univariate analysis was performed by using dynamic contrast-enhanced parameters and clinical factors. Factors that were significant on univariate analysis were entered into multivariate analysis.
RESULTS
For all patients with gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). In subgroups of high- and low-grade gliomas, survival was worse for groups of patients with high contrast transfer coefficient and plasma volume obtained in tumor (P < .05). Univariate analysis showed that factors associated with lower survival were age older than 50 years, low Karnofsky score, biopsy-only versus resection, marked contrast enhancement versus no/mild enhancement, high contrast transfer coefficient, and high plasma volume obtained in tumor (P < .05). In multivariate analysis, a low Karnofsky score, biopsy versus resection in combination with marked contrast enhancement, and a high contrast transfer coefficient were associated with lower survival rates (P < .05).
CONCLUSIONS
In patients with glioma, those with a high contrast transfer coefficient have lower survival than those with low parameters.
背景与目的
在胶质瘤患者中，由动态对比增强磁共振成像获得的肿瘤血浆容积及对比剂转移系数的预后价值尚未完全明确。我们确定了除年龄、手术类型、术前卡诺夫斯基评分、对比增强及组织病理学分级等其他因素外，肿瘤中的血浆容积和对比剂转移系数是否与胶质瘤患者的生存率相关。
材料与方法
这项前瞻性研究纳入了46例新确诊的病理证实的胶质瘤患者。肿瘤图中获得的对比剂转移系数和血浆容积直接根据信号强度曲线计算得出，无需测量T1值，且数值取自置于肿瘤内的多个小感兴趣区。通过将患者分为对比剂转移系数和血浆容积高、低两组进行生存曲线分析。采用动态对比增强参数和临床因素进行单因素分析。单因素分析中有显著意义的因素纳入多因素分析。
结果
对于所有胶质瘤患者，肿瘤中对比剂转移系数和血浆容积高的患者组生存率较差（P < 0.05）。在高级别和低级别胶质瘤亚组中，肿瘤中对比剂转移系数和血浆容积高的患者组生存率较差（P < 0.05）。单因素分析显示，与较低生存率相关的因素包括年龄大于50岁、卡诺夫斯基评分低、仅活检与切除、明显对比增强与无/轻度增强、对比剂转移系数高以及肿瘤中血浆容积高（P < 0.05）。多因素分析中，卡诺夫斯基评分低、活检与切除联合明显对比增强以及对比剂转移系数高与较低生存率相关（P < 0.05）。
结论
在胶质瘤患者中，对比剂转移系数高的患者生存率低于参数低的患者。
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