Qi Huaiju, Zheng Yu, Li Jiansheng, Chen Kaixuan, Zhou Li, Luo Dilin, Huang Shan, Zhang Jiahui, Lv Yongge, Tian Zhu
Department of Emergency, Shapingba Hospital, Chongqing University. people's hospital of Shapingba district, 400033, Chongqing, China.
Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, 400000, Chongqing, China.
Heliyon. 2024 May 29;10(11):e32111. doi: 10.1016/j.heliyon.2024.e32111. eCollection 2024 Jun 15.
To deepen the imaging-pathological mechanism of primary central nervous system lymphoma (PCNSL) and provide a theoretical basis for clinical diagnosis and treatment, the functional magnetic resonance imaging (fMRI) characteristics of PCNSL were analyzed, and the relationship between the fMRI characteristics and vasculogenic mimicry (VM) and reticular fiber in PCNSL was discussed.
Ninety-six patients with PCNSL treated in our hospital were divided into three groups according to the pathological examination results, including strong positive group of VM (n = 40), weak positive group of VM (n = 56), strong positive group of reticular fiber (n = 45) and weak positive group of reticular fiber (n = 51). The levels of augmentation index and apparent diffusion coefficient (ADC) were compared among the groups. receiver operator characteristic (ROC) curve analysis was used to analyze the clinical value of ADC value in differential diagnosis of PCNSL.
The levels of augmentation index in the strong positive group of VM were significantly higher than that in the weak positive group of VM, and the ADC value in the strong positive group of VM was significantly lower than that in the weak positive group of VM ( < 0.001). The levels of augmentation index in the strong positive group of reticular fiber were significantly higher than that in the weak positive group of reticular fiber, and ADC value in the strong positive group of reticular fiber was significantly lower than that in reticular fiber weak positive group ( < 0.001). Pearson correlation analysis showed that the levels of augmentation index were positively correlated with VM and reticular fiber (r = 0.529, 0.548, < 0.001) and the ADC value was negatively correlated with VM and reticular fiber (r = -0.485, -0.513, < 0.001). There was a significant negative correlation between necrotic lesions and VM (r = -0.185, < 0.05). The area under the curve (AUC) values of average ADC value, minimum ADC value, and maximum ADC value for individual differential diagnosis of PCNSL were 0.920, 0.901, and 0.702, while the AUC of the combined differential diagnosis was 0.985, with a sensitivity of 95.00 % and a specificity of 92.70 %.
The levels of augmentation index and the ADC value of PCNSL focus are significantly correlated with VM and reticular fiber, and there is a strong negative correlation between necrotic lesions and VM. MRI imaging technology is of great significance in revealing the biological behavior of PCNSL, which can effectively reveal the relationship between VM and reticular fibers and the MRI characteristics in PCNSL, thereby providing a new imaging basis for the clinical diagnosis and treatment of PCNSL.
为深入了解原发性中枢神经系统淋巴瘤（PCNSL）的影像 - 病理机制，为临床诊断和治疗提供理论依据，分析PCNSL的功能磁共振成像（fMRI）特征，并探讨其fMRI特征与PCNSL中血管生成拟态（VM）及网状纤维的关系。
将我院收治的96例PCNSL患者根据病理检查结果分为三组，包括VM强阳性组（n = 40）、VM弱阳性组（n = 56）、网状纤维强阳性组（n = 45）和网状纤维弱阳性组（n = 51）。比较各组的增强指数和表观扩散系数（ADC）水平。采用受试者工作特征（ROC）曲线分析ADC值在PCNSL鉴别诊断中的临床价值。
VM强阳性组的增强指数水平显著高于VM弱阳性组，VM强阳性组的ADC值显著低于VM弱阳性组（P < 0.001）。网状纤维强阳性组的增强指数水平显著高于网状纤维弱阳性组，网状纤维强阳性组的ADC值显著低于网状纤维弱阳性组（P < 0.001）。Pearson相关性分析显示，增强指数水平与VM和网状纤维呈正相关（r = 0.529，0.548，P < 0.001），ADC值与VM和网状纤维呈负相关（r = -0.485，-0.513，P < 0.001）。坏死灶与VM之间存在显著负相关（r = -0.185，P < 0.05）。PCNSL个体鉴别诊断的平均ADC值、最小ADC值和最大ADC值的曲线下面积（AUC）分别为0.920、0.901和0.702，联合鉴别诊断的AUC为0.985，敏感性为95.00%，特异性为92.70%。
PCNSL病灶的增强指数水平和ADC值与VM和网状纤维显著相关，坏死灶与VM之间存在较强的负相关。MRI成像技术在揭示PCNSL的生物学行为方面具有重要意义，能够有效揭示PCNSL中VM与网状纤维的关系及MRI特征，从而为PCNSL的临床诊断和治疗提供新的影像依据。
