Razek Ahmed Abdel Khalek Abdel, El-Serougy Lamiaa Galal, Abdelsalam Mohamed A, Gaballa Gada Mohamed, Talaat Mona Mohamed
Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Department of Neurology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Pol J Radiol. 2020 Feb 21;85:e110-e117. doi: 10.5114/pjr.2020.93397. eCollection 2020.
To assess arterial spin labelling (ASL) perfusion and diffusion MR imaging (DWI) in the differentiation of grade II from grade III gliomas.
A prospective cohort study was done on 36 patients (20 male and 16 female) with diffuse gliomas, who underwent ASL and DWI. Diffuse gliomas were classified into grade II and grade III. Calculation of tumoural blood flow (TBF) and apparent diffusion coefficient (ADC) of the tumoral and peritumoural regions was made. The ROC curve was drawn to differentiate grade II from grade III gliomas.
There was a significant difference in TBF of tumoural and peritumoural regions of grade II and III gliomas ( = 0.02 and =0.001, respectively). Selection of 26.1 and 14.8 ml/100 g/min as the cut-off for TBF of tumoural and peritumoural regions differentiated between both groups with area under curve (AUC) of 0.69 and 0.957, and accuracy of 77.8% and 88.9%, respectively. There was small but significant difference in the ADC of tumoural and peritumoural regions between grade II and III gliomas ( = 0.02 for both). The selection of 1.06 and 1.36 × 10 mm/s as the cut-off of ADC of tumoural and peritumoural regions was made, to differentiate grade II from III with AUC of 0.701 and 0.748, and accuracy of 80.6% and 80.6%, respectively. Combined TBF and ADC of tumoural regions revealed an AUC of 0.808 and accuracy of 72.7%. Combined TBF and ADC for peritumoural regions revealed an AUC of 0.96 and accuracy of 94.4%.
TBF and ADC of tumoural and peritumoural regions are accurate non-invasive methods of differentiation of grade II from grade III gliomas.
评估动脉自旋标记（ASL）灌注和扩散磁共振成像（DWI）在鉴别Ⅱ级和Ⅲ级胶质瘤中的作用。
对36例弥漫性胶质瘤患者（20例男性，16例女性）进行了前瞻性队列研究，这些患者均接受了ASL和DWI检查。弥漫性胶质瘤分为Ⅱ级和Ⅲ级。计算肿瘤及瘤周区域的肿瘤血流量（TBF）和表观扩散系数（ADC）。绘制ROC曲线以鉴别Ⅱ级和Ⅲ级胶质瘤。
Ⅱ级和Ⅲ级胶质瘤的肿瘤及瘤周区域TBF存在显著差异（分别为 = 0.02和 = 0.001）。选择26.1和14.8 ml/100 g/min作为肿瘤及瘤周区域TBF的截断值，两组间的区分度曲线下面积（AUC）分别为0.69和0.957，准确率分别为77.8%和88.9%。Ⅱ级和Ⅲ级胶质瘤的肿瘤及瘤周区域ADC存在微小但显著的差异（两者均为 = 0.02）。选择1.06和1.36×10 mm/s作为肿瘤及瘤周区域ADC的截断值，以鉴别Ⅱ级和Ⅲ级胶质瘤，AUC分别为0.701和0.748，准确率分别为80.6%和80.6%。肿瘤区域的联合TBF和ADC显示AUC为0.808，准确率为72.7%。瘤周区域的联合TBF和ADC显示AUC为0.96，准确率为94.4%。
肿瘤及瘤周区域的TBF和ADC是鉴别Ⅱ级和Ⅲ级胶质瘤的准确无创方法。
