Department of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Changping District, Beijing, 102218, China.
Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Neurol Sci. 2024 Jun;45(6):2845-2851. doi: 10.1007/s10072-024-07315-z. Epub 2024 Jan 16.
The aim of this study was to determine the usefulness of magnetic resonance imaging (MRI) characteristics in discriminating H3 K27M-mutant gliomas from wildtype gliomas in the spinal cord.
Fifty-eight patients with spinal cord gliomas were enrolled in this study. The H3 K27 gene status was identified by Sanger sequencing or immunohistochemistry test of resection tumor specimens. The MR imaging characteristics were evaluated and compared between H3 K27M-mutant and wildtype gliomas using the χ test and the Mann-Whitney U test.
Of 58 recruited patients, 23 (39.7%) were diagnosed with H3 K27M-mutant glioma. The H3 K27M-mutant gliomas were found to more likely occur in men compared with wildtype gliomas (87.0% vs. 42.9%, p = 0.001). On T2-weighted MR images, the signal-to-noise ratio (SNR) of H3 K27M-mutant gliomas was significantly lower than that of wildtype gliomas (103.9 ± 72.0 vs. 168.9 ± 86.8, p < 0.001). Of 35 wildtype tumors, 60% showed well-defined margin but this feature was not found in all mutant tumors (p < 0.001). The SNR of tumors on contrast-enhanced T1-weighted images of the H3 K27M-mutant gliomas was significantly lower than that of wildtype gliomas (187.7 ± 160.4 vs. 295.1 ± 207.8, p = 0.006). Receiver operating-characteristic analysis revealed that area under curve (AUC) of combination of 1/SNR on T2-weighted images, 1/SNR on contrast-enhanced T1-weighted images, ill-defined margin, and sex reached 0.937 (95% CI, 0.873-1.000) in discriminating H3 K27M-mutant gliomas.
The MR imaging characteristics are valuable in discriminating H3 K27M-mutant from wildtype gliomas in the spinal cord and the combination of these imaging features with sex had a high strength in this discrimination.
本研究旨在确定磁共振成像（MRI）特征在区分脊髓中 H3 K27M 突变型胶质瘤与野生型胶质瘤中的作用。
本研究纳入了 58 例脊髓胶质瘤患者。通过对切除肿瘤标本进行 Sanger 测序或免疫组织化学检测，确定 H3 K27 基因状态。使用 χ 检验和 Mann-Whitney U 检验评估并比较 H3 K27M 突变型和野生型胶质瘤的 MRI 特征。
在 58 名入组患者中，23 名（39.7%）被诊断为 H3 K27M 突变型胶质瘤。与野生型胶质瘤相比，H3 K27M 突变型胶质瘤更常见于男性（87.0%比 42.9%，p=0.001）。在 T2 加权 MRI 图像上，H3 K27M 突变型胶质瘤的信噪比（SNR）明显低于野生型胶质瘤（103.9±72.0 比 168.9±86.8，p<0.001）。在 35 例野生型肿瘤中，60%表现为边界清晰，但并非所有突变型肿瘤均具有此特征（p<0.001）。H3 K27M 突变型胶质瘤增强 T1 加权图像的 SNR 明显低于野生型胶质瘤（187.7±160.4 比 295.1±207.8，p=0.006）。受试者工作特征曲线分析显示，T2 加权图像 SNR 的倒数、增强 T1 加权图像 SNR 的倒数、边界不清和性别联合的曲线下面积（AUC）在区分 H3 K27M 突变型胶质瘤方面达到 0.937（95%CI，0.873-1.000）。
MRI 特征有助于区分脊髓中的 H3 K27M 突变型胶质瘤与野生型胶质瘤，这些影像学特征与性别联合具有较高的鉴别能力。
