Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China.
Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, PR China.
Eur J Radiol. 2017 Oct;95:286-292. doi: 10.1016/j.ejrad.2017.08.019. Epub 2017 Aug 24.
To explore the value of Diffusion kurtosis imaging (DKI) metrics in the differential diagnosis of meningioma.
For this study, we retrospectively enrolled 35 patients of cerebral meningioma with DKI which included axial diffusion coefficient (AD), radial diffusion coefficient (RD), mean diffusion coefficient (MD), fractional anisotropy (FA), axial kurtosis (AK), radial kurtosis (RK) and mean kurtosis (MK). All of these metrics were normalized according to contralateral normal-appearing white matter (NAWMc). Patients were divided into two groups (benign and malignant meningioma) and were further analyzed using the independent sample t-test and receiver operating characteristic (ROC) curve. A one-way ANOVA analysis was used to analyze four groups divided according to pathological subtypes.
The metrics of AD, normalized AD, normalized MD, MK and normalized MK showed a significant difference between benign and malignant group, and MK showed relatively higher diagnostic ability with its cut-off value, area under the curve (AUC), sensitivity and specificity of 0.875, 0.780, 70% and 89%, respectively. The metrics of normalized MD, RD and normalized RD, FA and normalized FA, AK and normalized AK, and RK showed significant difference among four subtypes. MK and RK in meningioma were found to correlate positively with the Ki-67 labeling index (Ki-67 LI).
DKI metrics may be used to differentiate benign from malignant meningioma, and also to distinguish some histological subtypes of meningioma. Moreover, DKI metrics may potentially reflect cellular proliferation.
探讨弥散峰度成像(DKI)指标在脑膜瘤鉴别诊断中的价值。
本研究回顾性纳入 35 例脑脑膜瘤患者的 DKI 资料,包括轴位扩散系数(AD)、径向扩散系数(RD)、平均扩散系数(MD)、各向异性分数(FA)、轴向峰度(AK)、径向峰度(RK)和平均峰度(MK)。所有这些指标均根据对侧正常白质(NAWMc)进行归一化。患者分为良性和恶性脑膜瘤两组,采用独立样本 t 检验和受试者工作特征(ROC)曲线进行进一步分析。采用单因素方差分析对根据病理亚型分为四组的患者进行分析。
AD、标准化 AD、标准化 MD、MK 和标准化 MK 等指标在良性和恶性组之间存在显著差异,MK 的截断值、曲线下面积(AUC)、敏感性和特异性分别为 0.875、0.780、70%和 89%,具有相对较高的诊断能力。标准化 MD、RD 和标准化 RD、FA 和标准化 FA、AK 和标准化 AK 以及 RK 等指标在四组亚型之间存在显著差异。MK 和 RK 在脑膜瘤中与 Ki-67 标记指数(Ki-67 LI)呈正相关。
DKI 指标可用于鉴别良恶性脑膜瘤,并有助于区分脑膜瘤的某些组织学亚型。此外,DKI 指标可能反映细胞增殖。