基于流入的血管空间占有率和弥散加权成像在脑胶质瘤术前分级中的附加价值。
The Added Value of Inflow-Based Vascular-Space-Occupancy and Diffusion-Weighted Imaging in Preoperative Grading of Gliomas.
机构信息
Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Neurosection, Division of MRI Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Meghalaya, USA.
出版信息
Neurodegener Dis. 2020;20(4):123-130. doi: 10.1159/000512545. Epub 2021 Mar 18.
OBJECTIVES
The present study aimed to study whether combined inflow-based vascular-space-occupancy (iVASO) MR imaging (MRI) and diffusion-weighted imaging (DWI) improve the diagnostic accuracy in the preoperative grading of gliomas.
METHODS
Fifty-one patients with histopathologically confirmed diffuse gliomas underwent preoperative structural MRI, iVASO, and DWI. We performed 2 qualitative consensus reviews: (1) structural MR images alone and (2) structural MR images with iVASO and DWI. Relative arteriolar cerebral blood volume (rCBVa) and minimum apparent diffusion coefficient (mADC) were compared between low-grade and high-grade gliomas. Receiver operating characteristic (ROC) curve analysis was performed to compare the tumor grading efficiency of rCBVa, mADC, and the combination of the two parameters.
RESULTS
Two observers diagnosed accurate tumor grade in 40 of 51 (78.4%) patients in the first review and in 46 of 51 (90.2%) in the second review. Both rCBVa and mADC showed significant differences between low-grade and high-grade gliomas. ROC analysis gave a threshold value of 1.52 for rCBVa and 0.85 × 10-3 mm2/s for mADC to provide a sensitivity and specificity of 88.0 and 81.2% and 100.0 and 68.7%, respectively. The area under the ROC curve (AUC) was 0.87 and 0.85 for rCBVa and mADC, respectively. The combination of rCBVa and mADC values increased the AUC to 0.92.
CONCLUSION
The combined application of iVASO and DWI may improve the diagnostic accuracy of glioma grading.
目的
本研究旨在探讨基于流入的血管空间占有率（iVASO）磁共振成像（MRI）和弥散加权成像（DWI）联合应用是否能提高术前胶质瘤分级的诊断准确性。
方法
51 例经组织病理学证实的弥漫性胶质瘤患者接受了术前结构 MRI、iVASO 和 DWI 检查。我们进行了 2 次定性共识审查：（1）仅结构 MRI 图像，（2）结构 MRI 图像加 iVASO 和 DWI。比较低级别和高级别胶质瘤的相对小动脉脑血容量（rCBVa）和最小表观弥散系数（mADC）。绘制受试者工作特征（ROC）曲线，比较 rCBVa、mADC 及两者联合对肿瘤分级的效能。
结果
在第一次审查中，两位观察者在 40/51（78.4%）例患者中准确诊断了肿瘤分级，在第二次审查中在 46/51（90.2%）例患者中准确诊断了肿瘤分级。rCBVa 和 mADC 均在低级别和高级别胶质瘤之间存在显著差异。ROC 分析得出 rCBVa 的阈值为 1.52，mADC 的阈值为 0.85×10-3mm2/s，其灵敏度和特异性分别为 88.0%和 81.2%，100.0%和 68.7%。ROC 曲线下面积（AUC）分别为 rCBVa 的 0.87 和 mADC 的 0.85。rCBVa 和 mADC 值的联合应用提高了 AUC 值，达到 0.92。
结论
iVASO 和 DWI 的联合应用可能提高胶质瘤分级的诊断准确性。
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