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动态磁敏感对比增强和扩散加权磁共振成像在胶质母细胞瘤患者中的预后价值

Prognostic Value of Dynamic Susceptibility Contrast-Enhanced and Diffusion-Weighted MR Imaging in Patients with Glioblastomas.

作者信息

Çoban G, Mohan S, Kural F, Wang S, O'Rourke D M, Poptani H

机构信息

From the Department of Radiology (G.Ç., F.K.), Baskent University School of Medicine, Ankara, Turkey Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).

Departments of Radiology (G.Ç., S.M., F.K., S.W., H.P.).

出版信息

AJNR Am J Neuroradiol. 2015 Jul;36(7):1247-52. doi: 10.3174/ajnr.A4284. Epub 2015 Apr 2.

Abstract

BACKGROUND AND PURPOSE

Prediction of survival in patients with glioblastomas is important for individualized treatment planning. This study aimed to assess the prognostic utility of presurgical dynamic susceptibility contrast and diffusion-weighted imaging for overall survival in patients with glioblastoma.

MATERIALS AND METHODS

MR imaging data from pathologically proved glioblastomas between June 2006 to December 2013 in 58 patients (mean age, 62.7 years; age range, 22-89 years) were included in this retrospective study. Patients were divided into long survival (≥15 months) and short survival (<15 months) groups, depending on overall survival time. Patients underwent dynamic susceptibility contrast perfusion and DWI before surgery and were treated with chemotherapy and radiation therapy. The maximum relative cerebral blood volume and minimum mean diffusivity values were measured from the enhancing part of the tumor.

RESULTS

Maximum relative cerebral blood volume values in patients with short survival were significantly higher compared with those who demonstrated long survival (P < .05). No significant difference was observed in the minimum mean diffusivity between short and long survivors. Receiver operator curve analysis demonstrated that a maximum relative cerebral blood volume cutoff value of 5.79 differentiated patients with low and high survival with an area under the curve of 0.93, sensitivity of 0.89, and specificity of 0.90 (P < .001), while a minimum mean diffusivity cutoff value of 8.35 × 10(-4)mm(2)/s had an area under the curve of 0.55, sensitivity of 0.71, and specificity of 0.47 (P > .05) in separating the 2 groups.

CONCLUSIONS

Maximum relative cerebral blood volume may be used as a prognostic marker of overall survival in patients with glioblastomas.

摘要

背景与目的

预测胶质母细胞瘤患者的生存期对于个体化治疗方案的制定至关重要。本研究旨在评估术前动态磁敏感对比增强成像和扩散加权成像对胶质母细胞瘤患者总生存期的预后价值。

材料与方法

本回顾性研究纳入了2006年6月至2013年12月期间58例经病理证实为胶质母细胞瘤患者的磁共振成像数据(平均年龄62.7岁;年龄范围22 - 89岁)。根据总生存时间,将患者分为长生存期(≥15个月)和短生存期(<15个月)两组。患者在手术前行动态磁敏感对比增强灌注和扩散加权成像检查,并接受化疗和放疗。从肿瘤强化部分测量最大相对脑血容量和最小平均扩散率值。

结果

短生存期患者的最大相对脑血容量值显著高于长生存期患者(P <.05)。短生存期和长生存期患者的最小平均扩散率未见显著差异。受试者工作特征曲线分析表明,最大相对脑血容量截断值为5.79时,区分低生存期和高生存期患者的曲线下面积为0.93,敏感性为0.89,特异性为0.90(P <.001);而最小平均扩散率截断值为8.35×10⁻⁴mm²/s时,区分两组的曲线下面积为0.55,敏感性为0.71,特异性为0.47(P >.05)。

结论

最大相对脑血容量可作为胶质母细胞瘤患者总生存期的预后标志物。

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