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表观扩散系数在预测脑膜瘤术前分级中的应用

Apparent Diffusion Coefficient in Predicting the Preoperative Grade of Meningiomas.

作者信息

Atalay Basak, Ediz Suna Sahin, Ozbay Nurver Ozel

机构信息

Department of Radiology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.

Department of Radiology, Kartal Dr. Lutfu Kırdar Training and Resarch Hospital, Istanbul, Turkey.

出版信息

J Coll Physicians Surg Pak. 2020 Nov;30(11):1126-1132. doi: 10.29271/jcpsp.2020.11.1126.

DOI:10.29271/jcpsp.2020.11.1126
PMID:33222726
Abstract

OBJECTIVE

To investigate the relationship between the apparent diffusion coefficients (ADC) value obtained from magnetic resonance imaging (MRI) and histopathologic grade of meningiomas.

STUDY DESIGN

Observational study.

PLACE AND DURATION OF STUDY

Department of Radiology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey between January 2015 and June 2019.

METHODOLOGY

Data of 45 patients with meningiomas, who underwent surgery at the University Hospital, were retrospectively reviewed; 28 patients were enrolled in the study. The pathology preparations of the patients were re-evaluated according to the World Health Organisation (WHO) 2016 classification updated by a neuropathologist. ADC values were measured in a standard region of interest range from the three consecutive sections where the mass had the largest width and from the opposite white matter.

RESULTS

Fourteen patients (50%) were diagnosed with WHO grade I tumor, 11 with grade II (39.3%), and three with grade III (10.7%). The ADCmin value was found statistically significant for the differentiation of tumor grades (p = 0.018). The cut-off point of the ADCmin value was 0.634x10-3mm2s for the differential diagnosis of grade I and grade II/III meningiomas. The sensitivity of the cut-off value was found as 86% and its specificity as 57%. The patients with increased cellularity and Ki67 proliferation index had statistically significantly lower ADCmin values (p = 0.025).

CONCLUSION

The data of this study show a significant difference in the ADCmin values on MRI between low- and high-grade meningiomas. A negative correlation was found between histopathologic grade and ADCmin. Key Words: Meningioma, Apparent diffusion coefficient, Magnetic resonance imaging, Histopathological grade, Quantitative.

摘要

目的

探讨磁共振成像(MRI)获得的表观扩散系数(ADC)值与脑膜瘤组织病理学分级之间的关系。

研究设计

观察性研究。

研究地点和时间

2015年1月至2019年6月期间,土耳其伊斯坦布尔梅迪尼耶特大学医学院放射科。

方法

回顾性分析在大学医院接受手术的45例脑膜瘤患者的数据;28例患者纳入研究。由神经病理学家根据世界卫生组织(WHO)2016年更新的分类对患者的病理标本进行重新评估。在肿块最大宽度的三个连续切片以及相对的白质的标准感兴趣区域内测量ADC值。

结果

14例患者(50%)被诊断为WHO I级肿瘤,11例为II级(39.3%),3例为III级(10.7%)。ADCmin值在肿瘤分级的鉴别上具有统计学意义(p = 0.018)。I级和II/III级脑膜瘤鉴别诊断的ADCmin值截断点为0.634x10-3mm2/s。截断值的敏感性为86%,特异性为57%。细胞增多和Ki67增殖指数升高的患者ADCmin值在统计学上显著较低(p = 0.025)。

结论

本研究数据显示低级别和高级别脑膜瘤在MRI上的ADCmin值存在显著差异。组织病理学分级与ADCmin之间存在负相关。关键词:脑膜瘤;表观扩散系数;磁共振成像;组织病理学分级;定量

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