表观扩散系数值和动态对比增强磁共振灌注成像可能是脑膜瘤分级的预测指标。
Apparent Diffusion Coefficient Values and Dynamic Contrast-Enhanced Magnetic Resonance Perfusion are Potential Predictors for Grading Meningiomas.
机构信息
Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Indonesia.
Department of Radiology, Faculty of Medicine, Universitas Airlangga, Indonesia.
出版信息
Int J Med Sci. 2022 Jul 18;19(9):1364-1376. doi: 10.7150/ijms.75092. eCollection 2022.
: Distinguishing between high-grade and low-grade meningiomas might be difficult but has high clinical value in deciding precise treatment and prognostic factors. Magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values and dynamic contrast enhancement (DCE) may have a significant role in capturing such complexities. : Data from our hospital database on meningioma patients from January 2020 to December 2021 were obtained. The MRI results of all patients were evaluated for mean ADC value and DCE parameters, including time-signal intensity curves (TIC), maximum signal intensity (SImax), time to maximum signal intensity (Tmax), maximum contrast enhancement ratio (MCER), and slope. : In this retrospective analysis, 33 individuals were included. Twenty-eight (84.8%) patients were pathologically diagnosed with low-grade meningioma and five (15.2%) patients with high-grade meningioma. There is a crossover between high- and low-grade meningiomas in conventional MRI. Tumor size, location, shape, necrotic/cystic changes, peritumoral edema, and enhancement patterns did not differ substantially between groups ( = 0.39, 0.23, 0.28, 0.57, 0.56, and 0.33, respectively). The mean ADC and Tmax values of high-grade meningiomas were substantially lower than those of low-grade meningiomas ( = 0.002 and 0.02, respectively). An optimal cut-off of 0.87 × 10 mms for the mean ADC value (area under the curve [AUC] = 0.94, sensitivity = 80%, specificity = 92.8%) and 42 s for Tmax (AUC = 0.84, sensitivity = 80%, specificity = 89.3%) was suggested. High-grade meningiomas had significantly higher TIC, SImax, MCER, and slope than low-grade meningiomas ( = 0.004, < 0.001, 0.01, and 0.001, respectively). Type IV TIC had a sensitivity of 80% and specificity of 89.3% in distinguishing high-grade meningiomas from low-grade meningiomas. Optimal cut-offs of 940.2 for SImax (AUC = 0.98, sensitivity = 80%, specificity = 96.4%), 245% for MCER (AUC = 0.94, sensitivity = 80%, specificity = 85.7%), and 5% per second for slope (AUC = 0.97, sensitivity = 80%, specificity = 96.4%) were estimated. : The ADC value and DCE-MRI parameters (TIC, SImax, Tmax, MCER, and slope) are potential predictors for separating high-grade from low-grade meningiomas.
高级别和低级别脑膜瘤之间的鉴别可能具有挑战性，但在确定精确的治疗和预后因素方面具有重要的临床价值。磁共振成像（MRI）使用表观扩散系数（ADC）值和动态对比增强（DCE）可能在捕捉这些复杂性方面发挥重要作用。
从 2020 年 1 月至 2021 年 12 月，我们从医院数据库中获得了脑膜瘤患者的数据。评估了所有患者的 MRI 结果，包括平均 ADC 值和 DCE 参数，包括时间信号强度曲线（TIC）、最大信号强度（SImax）、达到最大信号强度的时间（Tmax）、最大对比增强比（MCER）和斜率。
在这项回顾性分析中，纳入了 33 人。28 人（84.8%）经病理诊断为低级别脑膜瘤，5 人（15.2%）为高级别脑膜瘤。在常规 MRI 中，高级别和低级别脑膜瘤之间存在交叉。肿瘤大小、位置、形状、坏死/囊性改变、瘤周水肿和强化模式在组间无显著差异（=0.39、0.23、0.28、0.57、0.56 和 0.33）。高级别脑膜瘤的平均 ADC 和 Tmax 值明显低于低级别脑膜瘤（=0.002 和 0.02）。平均 ADC 值的最佳截断值为 0.87×10 mms（曲线下面积[AUC]为 0.94，敏感性为 80%，特异性为 92.8%），Tmax 为 42s（AUC 为 0.84，敏感性为 80%，特异性为 89.3%）。高级别脑膜瘤的 TIC、SImax、MCER 和斜率明显高于低级别脑膜瘤（=0.004、<0.001、0.01 和 0.001）。IV 型 TIC 在鉴别高级别脑膜瘤和低级别脑膜瘤方面具有 80%的敏感性和 89.3%的特异性。SImax 的最佳截断值为 940.2（AUC=0.98，敏感性为 80%，特异性为 96.4%），MCER 的最佳截断值为 245%（AUC=0.94，敏感性为 80%，特异性为 85.7%），斜率的最佳截断值为 5%/s（AUC=0.97，敏感性为 80%，特异性为 96.4%）。
ADC 值和 DCE-MRI 参数（TIC、SImax、Tmax、MCER 和斜率）可能是区分高级别和低级别脑膜瘤的潜在预测因素。
Zotero 插件