灌注 CT 可检测到与 IDH、MGMT 和 TERT 状态相关的脑胶质瘤局部脑血流变化。

METHODS

Forty-six patients with glioma were involved in the study. Histopathologic and molecular pathology diagnoses were obtained by tumor resection, and all patients accepted perfusion computed tomography (PCT) before operation. Regions of interests were placed manually at tumor and contralateral normal-appearing thalamus. The parameters of tumor were divided by those of contralateral normal-appearing thalamus to normalize at tumor (relative [r] CBV, rCBF, rMTT, rTTP, rPS). The relationships of the parameters, world health organization (WHO) grade, molecular pathological findings were analysed.

RESULTS

The rCBV, rMTT and rPS of patients are positively related to the pathological classification (P < 0.05). The values of rCBV and rPS in IDH mutated patients were lower than those IDH wild-type. The values of rCBF in patients with MGMT methylation were lower than those MGMT unmethylation (P < 0.05). The MVD of TERT wild-type group was lower than TERT mutated group (P < 0.05). The values of rCBV were significant difference in the four molecular groups divided by the combined IDH/TERT classification (P < 0.05). The progression free survival (PFS) and overall survival (OS) were significant difference in the four molecular groups divided by the combined IDH/TERT classification (P < 0.05).

CONCLUSIONS

Our study introduces and supports the changes of glioma flow perfusion may be closely related to its biological characteristics.

背景

本研究旨在探讨脑血流容积（CBV）、脑血流（CBF）、平均通过时间（MTT）、达峰时间（TTP）、肿瘤渗透性表面积（PS）等肿瘤生物学指标与脑胶质瘤患者肿瘤之间的关系。

方法

本研究纳入 46 例脑胶质瘤患者。通过肿瘤切除术获得组织病理学和分子病理学诊断，所有患者均在术前接受灌注 CT（PCT）检查。手动在肿瘤和对侧正常丘脑区域放置感兴趣区。将肿瘤的参数除以对侧正常丘脑的参数，以对肿瘤进行归一化（相对 [r] CBV、rCBF、rMTT、rTTP、rPS）。分析参数与世界卫生组织（WHO）分级、分子病理发现之间的关系。

结果

患者的 rCBV、rMTT 和 rPS 与病理分级呈正相关（P<0.05）。IDH 突变患者的 rCBV 和 rPS 值低于 IDH 野生型患者。MGMT 甲基化患者的 rCBF 值低于 MGMT 非甲基化患者（P<0.05）。TERT 野生型组的 MVD 低于 TERT 突变型组（P<0.05）。联合 IDH/TERT 分类的四个分子组之间 rCBV 值差异有统计学意义（P<0.05）。联合 IDH/TERT 分类的四个分子组之间无进展生存期（PFS）和总生存期（OS）差异有统计学意义（P<0.05）。