Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China.
Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, China.
J Clin Neurosci. 2021 Jan;83:56-63. doi: 10.1016/j.jocn.2020.11.030. Epub 2020 Dec 15.
In order to assess combined application of MRS and DWI for prediction cell proliferation and grade diagnosis of glioma, We prospectively collected the Cho/Cr, Cho/NAA, Cr/NAA of MRS and tumor parenchyma ADC (ADC), contralateral mirror brain tissue ADC (ADC), rADC (rADC = ADC/ADC). According to postoperative pathology, the patients were divided into two groups: LGG group and HGG group, compared differences of age, gender, Ki67, MRS, DWI between two groups. Next, we analyzed the correlation between MRS, DWI and Ki67. On this basis, the sensitivity and specificity of MRS, DWI and MRS combined with DWI (MRS + DWI) in diagnosis of glioma grade were evaluated. The differences of Ki67, Cho/Cr, Cho/NAA, Cr/NAA, ADC, rADC between LGG group and HGG group were statistically significant (p = 0.000, 0.000, 0.000, 0.008, 0.000, and 0.000 respectively). From ROC curve, area under the curve (AUC), sensitivity and specificity of Cho/Cr, Cho/NAA, Cr/NAA, ADC, rADC, PRE (MRS + DWI) were (0.901, 86.7%, 85.7%), (0.876, 80.0%, 82.1%), (0.704, 63.3%, 71.4%), (0.862, 82.1%, 83.3%), (0.820, 75.0%, 76.7%), (0.920, 86.7%, 89.3%), respectively. Fisher's linear discriminant functions results suggest: Y = -20.447 + 3.46•X + 17.141•X (LGG), Y = -19.415 + 4.828•X + 14.543•X (HGG). Our study suggested that MRS and DWI can effectively predict cell proliferation preoperative. MRS combined with DWI can further improve sensitivity and specificity in assessing the grade of glioma.
为了评估 MRS 和 DWI 联合应用于预测脑胶质瘤细胞增殖和分级诊断，我们前瞻性地收集了 MRS 的 Cho/Cr、Cho/NAA、Cr/NAA 和肿瘤实质 ADC（ADC）、对侧镜像脑组织 ADC（ADC）、rADC（rADC=ADC/ADC）。根据术后病理，将患者分为 LGG 组和 HGG 组，比较两组的年龄、性别、Ki67、MRS、DWI 差异。接下来，我们分析了 MRS、DWI 与 Ki67 的相关性。在此基础上，评估了 MRS、DWI 及 MRS 联合 DWI（MRS+DWI）在诊断脑胶质瘤分级中的灵敏度和特异度。LGG 组和 HGG 组之间 Ki67、Cho/Cr、Cho/NAA、Cr/NAA、ADC、rADC 的差异均有统计学意义（p=0.000、0.000、0.000、0.008、0.000、0.000）。从 ROC 曲线、曲线下面积（AUC）、Cho/Cr、Cho/NAA、Cr/NAA、ADC、rADC、PRE（MRS+DWI）的灵敏度和特异度分别为（0.901、86.7%、85.7%）、（0.876、80.0%、82.1%）、（0.704、63.3%、71.4%）、（0.862、82.1%、83.3%）、（0.820、75.0%、76.7%）、（0.920、86.7%、89.3%）。Fisher 线性判别函数结果提示：Y=-20.447+3.46·X+17.141·X（LGG），Y=-19.415+4.828·X+14.543·X（HGG）。本研究表明，MRS 和 DWI 可有效预测脑胶质瘤术前细胞增殖，MRS 联合 DWI 可进一步提高评估脑胶质瘤分级的灵敏度和特异度。
