College of Medical Imaging, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Department of MRI, The Sixth Hospital, Shanxi Medical University, Taiyuan 030008, Shanxi Province, China.
Contrast Media Mol Imaging. 2022 Jul 22;2022:5680522. doi: 10.1155/2022/5680522. eCollection 2022.
The objective of this study was to determine the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing postoperative changes in intracranial gliomas.
A total of fifty-one patients who had new enhanced lesions after surgical resection followed by standard radiotherapy and chemotherapy were collected retrospectively from October 2014 to June 2021. The patients were divided into a pseudoprogression group (15 cases) and a recurrence group (36 cases) according to the pathological results of the second operation or a follow-up of more than six months. The follow-up data of all patients were complete, and DCE-MRI was performed. The images were processed to obtain the quantitative parameters , Ve, and Kep and the semiquantitative parameter iAUC, which were analysed with relevant statistical software.
First, the difference in and iAUC values between the two groups was statistically significant ( ), and the difference in Ve and Kep values was not statistically significant ( ). Second, by comparing the area under the curve, threshold, sensitivity and specificity of , and iAUC, it was found that the iAUC threshold value was slightly higher than that of , and the specificity of was equal to that of iAUC, while the area under the curve and sensitivity of were higher than those of iAUC. Third, and iAUC had high accuracy in diagnosing recurrence and pseudoprogression, and had higher accuracy than iAUC.
In this study, DCE-MRI has a certain diagnostic value in the early differentiation of recurrence and pseudoprogression, offering a new method for the diagnosis and assessment of gliomas after surgery.
本研究旨在探讨动态对比增强磁共振成像(DCE-MRI)在评估颅内胶质瘤术后变化中的价值。
回顾性收集 2014 年 10 月至 2021 年 6 月间 51 例手术切除后继以标准放化疗后出现新增强病灶的患者。根据第二次手术或随访时间超过 6 个月的病理结果,将患者分为假性进展组(15 例)和复发组(36 例)。所有患者的随访资料完整,均行 DCE-MRI 检查,对图像进行处理获得定量参数 、Ve 和 Kep 以及半定量参数 iAUC,并采用相关统计软件进行分析。
首先,两组 值和 iAUC 值差异有统计学意义( ),Ve 和 Kep 值差异无统计学意义( )。其次,通过比较曲线下面积、阈值、敏感度和特异度,发现 iAUC 的阈值略高于 , 的特异度与 iAUC 相等,而曲线下面积和敏感度均高于 iAUC。再次, 和 iAUC 对复发和假性进展的诊断准确率较高,且 准确率高于 iAUC。
本研究表明,DCE-MRI 对复发和假性进展的早期鉴别具有一定的诊断价值,为术后胶质瘤的诊断和评估提供了一种新方法。