Department of Radiology, Hanoi Medical University, Hanoi, Vietnam.
Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam.
Clin Ter. 2024 Jul-Aug;175(4):239-245. doi: 10.7417/CT.2024.5070.
This study aimed to investigate the role of 3 Tesla Dif-fusion tensor imaging (DTI) in the assessment of brainstem glioma (BSG) grading.
The study comprised 22 patients, including pathology-proven 6 brainstem low-grade gliomas (BS-LGG) and 16 brainstem high-grade gliomas (BS-HGG). Characteristics including age, gender, fractional anisotropy (FA), mean diffusivity (MD) of the tumor, peritumoral region, and the ratio of tumor FA to parenchymal FA, as well as tumor MD to parenchymal MD (rFA and rMD), were compared using Mann-Whitney U test, Shapiro-Wilk test, and Chi-square test. Receiver operating characteristic (ROC) curve analysis was used in the study to determine cut-off values and diagnostic values for grading brainstem gliomas (BSG) using diffusion tensor imaging (DTI).
Our study revealed no significant difference in age and gender between the BS-LGG and BS-HGG groups (p>0.05). Fractional anisotropy (FA) indices on DTI MRI were found to be highly valuable in grading BSG, with an area under the curve (AUC) of 0.958 - 0.979 when using cut-off values of tFA, pFA, rtFA, and rpFA at 0.318, 0.378, 0.424, and 0.517, respectively. Particularly, rtFA demonstrated the hi-ghest diagnostic value with a sensitivity (Se) of 100%, specificity (Sp) of 93.8%, and AUC of 0.079. Conversely, the indices of tumor mean diffusivity (tMD), peritumoral edema region mean diffusivity (pMD), rtMD, and rpMD showed no diagnostic value in grading BSG.
The fractional anisotropy (FA) value on DTI between the tumor region and normal brain parenchyma holds significant value in diagnosing brainstem gliomas (BSG) grading, thereby playing a crucial role in treatment planning and predicting outcomes for patients with brainstem gliomas.
本研究旨在探讨 3 特斯拉弥散张量成像（DTI）在评估脑干胶质瘤（BSG）分级中的作用。
本研究纳入了 22 例患者，包括经病理证实的 6 例脑干低级别胶质瘤（BS-LGG）和 16 例脑干高级别胶质瘤（BS-HGG）。采用 Mann-Whitney U 检验、Shapiro-Wilk 检验和卡方检验比较患者的年龄、性别、肿瘤部位各向异性分数（FA）、平均弥散度（MD）、肿瘤周围区域及肿瘤与正常脑实质 FA 比值（rFA）和 MD 比值（rMD）。应用受试者工作特征（ROC）曲线分析确定 DTI 评估脑干胶质瘤（BSG）分级的截断值和诊断价值。
BS-LGG 和 BS-HGG 两组患者的年龄和性别差异无统计学意义（p>0.05）。FA 值在 DTI 上对 BSG 分级有较高的诊断价值，使用 tFA、pFA、rtFA 和 rpFA 的截断值分别为 0.318、0.378、0.424 和 0.517 时，FA 值的曲线下面积（AUC）为 0.958~0.979。其中 rtFA 的诊断价值最高，敏感度（Se）为 100%，特异度（Sp）为 93.8%，AUC 为 0.079。而肿瘤平均弥散度（tMD）、肿瘤周围水肿区平均弥散度（pMD）、rtMD 和 rpMD 指数对 BSG 分级无诊断价值。
肿瘤区与正常脑实质的弥散张量成像（DTI）FA 值在诊断脑干胶质瘤（BSG）分级中具有重要价值，对脑干胶质瘤患者的治疗计划和预后预测具有重要作用。
