基于流入相关血管空间占有率 MRI 的脑胶质瘤分级相关性：3T 初步研究。
Association of Glioma Grading With Inflow-Based Vascular-Space-Occupancy MRI: A Preliminary Study at 3T.
机构信息
Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China.
Division of CT & MR, Radiology Department, First Affiliated Hospital of Gannan Medical University, Ganzhou, P.R. China.
出版信息
J Magn Reson Imaging. 2019 Dec;50(6):1817-1823. doi: 10.1002/jmri.26741. Epub 2019 Apr 1.
BACKGROUND
Inflow-based vascular-space-occupancy (iVASO) MRI is a noninvasive perfusion technique that does not require administration of exogenous contrast agents. Arteriolar cerebral blood volume (CBVa) obtained from iVASO MRI is hypothesized to be an indicator of tumor microvasculature.
PURPOSE
To assess the diagnostic performance of iVASO MRI implemented at 3T in predicting histologic grades of cerebral gliomas.
STUDY TYPE
Retrospective.
SUBJECTS
Forty-five patients (31 males) consisting of 14 WHO grade IV glioblastoma multiformes, 14 grade III, and 17 grade II gliomas.
FIELD STRENGTH/SEQUENCE: At 3T we acquired CBVa data using an iVASO sequence.
ASSESSMENT
The maximum and mean CBVa (CBVa_max and CBVa_mean) values were calculated in the tumor and normalized to the contralateral thalamus (nCBVa_max and nCBVa_mean).
STATISTICAL TESTS
Kruskal-Wallis test, Mann-Whitney test, and receiver operating characteristics (ROC) curve were used for statistical analysis.
RESULTS
Both CBVa_max and nCBVa_max increased with tumor grade (P < 0.001). Grade II gliomas showed CBVa_max <0.78 ml / 100 ml in 10/17 cases and nCBVa_max <1.20 in 11/17 cases. Grade III gliomas showed both CBVa_max >0.78 ml / 100 ml and nCBVa_max >1.20 in 13/14 cases, and CBVa_max <2.06 ml / 100 ml in 13/14 cases and nCBVa_max <2.33 in 11/14 cases. Grade IV gliomas showed CBVa_max >2.06 ml / 100 ml in 9/14 cases and nCBVa_max >2.33 in 13/14 cases. The areas under the ROC curve, sensitivity, and specificity were 0.839 (P < 0.001), 92.9% (26/28), and 64.7% (11/17) for CBVa_max, and 0.883 (P < 0.001), 92.9% (26/28), and 70.6% (12/17) for nCBVa_max in the discrimination between grade II and high-grade (grade III and grade IV) tumors, respectively. DATA CONCLUSION: iVASO MRI might be used to help determine and predict glioma grade.
LEVEL OF EVIDENCE
4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1817-1823.
背景
血流空间占用（iVASO）MRI 是一种非侵入性的灌注技术，不需要使用外源性对比剂。从 iVASO MRI 获得的小动脉脑血容量（CBVa）被假设为肿瘤微血管的指标。
目的
评估在 3T 实施 iVASO MRI 预测脑胶质瘤组织学分级的诊断性能。
研究类型
回顾性。
受试者
45 名患者（31 名男性），包括 14 名 WHO 四级多形性胶质母细胞瘤、14 名三级和 17 名二级胶质瘤患者。
磁场强度/序列：在 3T 我们使用 iVASO 序列获取 CBVa 数据。
评估
在肿瘤中计算最大和平均 CBVa（CBVa_max 和 CBVa_mean）值，并将其与对侧丘脑归一化（nCBVa_max 和 nCBVa_mean）。
统计检验
使用 Kruskal-Wallis 检验、Mann-Whitney 检验和受试者工作特征（ROC）曲线进行统计分析。
结果
CBVa_max 和 nCBVa_max 均随肿瘤分级而增加（P < 0.001）。二级胶质瘤 17 例中有 10 例 CBVa_max <0.78ml/100ml，17 例中有 11 例 nCBVa_max <1.20。三级胶质瘤 14 例均表现为 CBVa_max >0.78ml/100ml 和 nCBVa_max >1.20，14 例中有 13 例 CBVa_max <2.06ml/100ml，14 例中有 11 例 nCBVa_max <2.33。四级胶质瘤 14 例中有 9 例 CBVa_max >2.06ml/100ml，14 例中有 13 例 nCBVa_max >2.33。ROC 曲线下面积、灵敏度和特异性分别为 0.839（P < 0.001）、92.9%（26/28）和 64.7%（11/17），用于 CBVa_max；0.883（P < 0.001）、92.9%（26/28）和 70.6%（12/17）用于 nCBVa_max 来区分二级和高级别（三级和四级）肿瘤。
数据结论
iVASO MRI 可能用于帮助确定和预测胶质瘤分级。
证据水平
4 级技术功效：第 2 阶段。磁共振成像 2019；50:1817-1823。
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