Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Department of Neuroimaging, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Clin Radiol. 2019 Aug;74(8):651.e7-651.e14. doi: 10.1016/j.crad.2019.03.020. Epub 2019 Apr 20.
To assess the diagnostic performance of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs), and predicting the isocitrate dehydrogenase 1 (IDH1) mutational status.
IVIM imaging was performed preoperatively in 42 patients with gliomas using 10 b-values (0-1,200 s/mm) in a 3 T MRI machine. The perfusion fraction (f), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and apparent diffusion coefficient (ADC) were calculated within the tumours and in the contralateral normal white matter, and the values were compared between the HGGs and LGGs, and between IDH1 wild-type and mutated-type gliomas. In addition, the receiver operating characteristic (ROC) was also analysed.
When compared to LGGs, HGGs had lower ADC (0.989×10 versus 1.243×10 mm/s, p<0.001), smaller D (0.849×10 versus 1.062×10 mm/s, p=0.001), larger D* (9.731×10 versus 5.442×10 mm/s, p=0.006), and bigger f-values (0.204 versus 0.130, p<0.001) within the tumours. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.937, 0.898, 0.770, and 0.838, respectively. Among the LGGs, tumours with the IDH1 mutation had a higher ADC (1.286×10 mm/s), when compared to the wild-type IDH1 (1.122×10 mm/s, p=0.003), with an AUC of 0.936. In HGGs, tumours with the IDH1 mutation had higher ADC (1.056×1010 versus 0.946×10 mm/s, p=0.030), smaller D* (6.204×10 versus 11.999×10 mm/s, p=0.023) and smaller f-values (0.143 versus 0.244, p<0.001), with an AUC of 0.766, 0.841 and 0.992, respectively.
Glioma grading can be differentiated and IDH1 mutational status can be predicted using IVIM.
评估体素内不相干运动（IVIM）磁共振成像（MRI）在区分高级别胶质瘤（HGG）和低级别胶质瘤（LGG）、预测异柠檬酸脱氢酶 1（IDH1）突变状态方面的诊断性能。
在 3T MRI 机上对 42 名胶质瘤患者进行术前 IVIM 成像，使用 10 个 b 值（0-1,200 s/mm）。在肿瘤内和对侧正常白质内计算灌注分数（f）、真实扩散系数（D）、假性扩散系数（D*）和表观扩散系数（ADC），并比较 HGG 和 LGG 之间以及 IDH1 野生型和突变型胶质瘤之间的差异。此外，还进行了受试者工作特征（ROC）分析。
与 LGG 相比，HGG 的 ADC 值更低（0.989×10 比 1.243×10 mm/s，p<0.001），D 值更小（0.849×10 比 1.062×10 mm/s，p=0.001），D值更大（9.731×10 比 5.442×10 mm/s，p=0.006），f 值更大（0.204 比 0.130，p<0.001）。ROC 曲线下面积（AUC）分别为 0.937、0.898、0.770 和 0.838。在 LGG 中，IDH1 突变型肿瘤的 ADC 值（1.286×10 mm/s）高于 IDH1 野生型（1.122×10 mm/s，p=0.003），AUC 为 0.936。在 HGG 中，IDH1 突变型肿瘤的 ADC 值更高（1.056×1010 比 0.946×10 mm/s，p=0.030），D值更小（6.204×10 比 11.999×10 mm/s，p=0.023），f 值更小（0.143 比 0.244，p<0.001），AUC 分别为 0.766、0.841 和 0.992。
IVIM 可用于区分胶质瘤分级和预测 IDH1 突变状态。
