使用单指数、双指数和拉伸指数扩散加权磁共振成像及扩散峰度磁共振成像对胶质瘤进行分级
Grading of Gliomas by Using Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MR Imaging and Diffusion Kurtosis MR Imaging.
作者信息
Bai Yan, Lin Yusong, Tian Jie, Shi Dapeng, Cheng Jingliang, Haacke E Mark, Hong Xiaohua, Ma Bo, Zhou Jinyuan, Wang Meiyun
机构信息
From the Department of Radiology, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, Henan 450003, China (Y.B., D.S., B.M., M.W.); Software Technology School of Zhengzhou University (Y.L.); Institute of Automation, Chinese Academy of Sciences, Beijing, China (J.T.); Division of MRI, First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, China (J.C.); Department of Radiology, Wayne State University, Detroit, Mich (E.M.H.); Magnetic Resonance Innovations, Detroit, Mich (E.M.H.); and Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, Md (X.H., B.M., J.Z., M.W.).
出版信息
Radiology. 2016 Feb;278(2):496-504. doi: 10.1148/radiol.2015142173. Epub 2015 Jul 31.
PURPOSE
To quantitatively compare the potential of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models and diffusion kurtosis imaging in the grading of gliomas.
MATERIALS AND METHODS
This study was approved by the local ethics committee, and written informed consent was obtained from all subjects. Both diffusion-weighted imaging and diffusion kurtosis imaging were performed in 69 patients with pathologically proven gliomas by using a 3-T magnetic resonance (MR) imaging unit. An isotropic apparent diffusion coefficient (ADC), true ADC, pseudo-ADC, and perfusion fraction were calculated from diffusion-weighted images by using a biexponential model. A water molecular diffusion heterogeneity index and distributed diffusion coefficient were calculated from diffusion-weighted images by using a stretched exponential model. Mean diffusivity, fractional anisotropy, and mean kurtosis were calculated from diffusion kurtosis images. All values were compared between high-grade and low-grade gliomas by using a Mann-Whitney U test. Receiver operating characteristic and Spearman rank correlation analysis were used for statistical evaluations.
RESULTS
ADC, true ADC, perfusion fraction, water molecular diffusion heterogeneity index, distributed diffusion coefficient, and mean diffusivity values were significantly lower in high-grade gliomas than in low-grade gliomas (U = 109, 56, 129, 6, 206, and 229, respectively; P < .05). Pseudo-ADC and mean kurtosis values were significantly higher in high-grade gliomas than in low-grade gliomas (U = 98 and 8, respectively; P < .05). Both water molecular diffusion heterogeneity index (area under the receiver operating characteristic curve [AUC] = 0.993) and mean kurtosis (AUC = 0.991) had significantly greater AUC values than ADC (AUC = 0.866), mean diffusivity (AUC = 0.722), and fractional anisotropy (AUC = 0.500) in the differentiation of low-grade and high-grade gliomas (P < .05).
CONCLUSION
Water molecular diffusion heterogeneity index and mean kurtosis values may provide additional information and improve the grading of gliomas compared with conventional diffusion parameters.
目的
定量比较从单指数、双指数和拉伸指数扩散加权成像模型以及扩散峰度成像获得的各种扩散参数在胶质瘤分级中的潜力。
材料与方法
本研究经当地伦理委员会批准，并获得所有受试者的书面知情同意。使用3-T磁共振（MR）成像设备对69例经病理证实的胶质瘤患者进行了扩散加权成像和扩散峰度成像。通过双指数模型从扩散加权图像中计算出各向同性表观扩散系数（ADC）、真实ADC、伪ADC和灌注分数。通过拉伸指数模型从扩散加权图像中计算出水分子扩散异质性指数和分布扩散系数。从扩散峰度图像中计算出平均扩散率、分数各向异性和平均峰度。使用Mann-Whitney U检验比较高级别和低级别胶质瘤之间的所有值。采用受试者工作特征曲线和Spearman等级相关分析进行统计学评估。
结果
高级别胶质瘤的ADC、真实ADC、灌注分数、水分子扩散异质性指数、分布扩散系数和平均扩散率值显著低于低级别胶质瘤（U分别为109、56、129、6、206和229；P < 0.05）。高级别胶质瘤的伪ADC和平均峰度值显著高于低级别胶质瘤（U分别为98和8；P < 0.05）。在低级别和高级别胶质瘤的鉴别中，水分子扩散异质性指数（受试者工作特征曲线下面积[AUC] = 0.993）和平均峰度（AUC = 0.991）的AUC值均显著大于ADC（AUC = 0.866）、平均扩散率（AUC = 0.722）和分数各向异性（AUC = 0.500）（P < 0.05）。
结论
与传统扩散参数相比，水分子扩散异质性指数和平均峰度值可能提供额外信息并改善胶质瘤分级。
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