Liang Weiqiang, Sun Wenbo, Li Chunyan, Zhou Jie, Long Changyou, Li Huan, Xu Dan, Xu Haibo
Department of Radiology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
Hubei Provincial Engineering Research Center of Multimodal Medical Imaging Technology and Clinical Application, Wuhan, China.
Cancer Imaging. 2025 Apr 7;25(1):51. doi: 10.1186/s40644-025-00868-y.
Gliomas may impair glymphatic function and alter cerebrospinal fluid (CSF) dynamics through structural brain changes, potentially affecting peritumoral brain edema (PTBE) and fluid clearance. This study investigated the impact of gliomas on glymphatic system function and CSF volume via diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) and volumetric magnetic resonance imaging (MRI), which clarified the relationships between tumor characteristics and glymphatic system disruption.
In this prospective study, 112 glioma patients and 56 healthy controls underwent MRI to calculate DTI-ALPS indices and perform volumetric analyses of CSF, tumor, and PTBE. Statistical analyses were used to assess the relationships between the DTI-ALPS index, tumor volume, PTBE volume, and clinical characteristics.
Glioma patients had significantly lower DTI-ALPS indices (1.266 ± 0.258 vs. 1.395 ± 0.174, p < 0.001) and greater CSF volumes (174.53 ± 34.89 cm³ vs. 154.25 ± 20.89 cm³, p < 0.001) than controls did. The DTI-ALPS index was inversely correlated with tumor volume (r = -0.353, p < 0.001) and PTBE volume (r = -0.266, p = 0.015). High-grade gliomas were associated with lower DTI-ALPS indices and larger PTBE volumes (all p < 0.001). Tumor grade emerged as an independent predictor of the DTI-ALPS index in multivariate analysis (β = -0.244, p = 0.011).
Gliomas are associated with significant glymphatic dysfunction, as evidenced by reduced DTI-ALPS indices and increased CSF and PTBE volumes. The DTI-ALPS index serves as a potential biomarker of glymphatic disruption in glioma patients, offering insights into tumor-related fluid changes and the pathophysiology of brain-tumor interactions.
胶质瘤可能通过脑部结构改变损害类淋巴系统功能并改变脑脊液（CSF）动力学，这可能会影响瘤周脑水肿（PTBE）和液体清除。本研究通过沿血管周围间隙的扩散张量成像分析（DTI-ALPS）和容积磁共振成像（MRI），研究了胶质瘤对类淋巴系统功能和脑脊液体积的影响，从而阐明了肿瘤特征与类淋巴系统破坏之间的关系。
在这项前瞻性研究中，112例胶质瘤患者和56名健康对照者接受了MRI检查，以计算DTI-ALPS指数并对脑脊液、肿瘤和PTBE进行容积分析。采用统计分析评估DTI-ALPS指数、肿瘤体积、PTBE体积和临床特征之间的关系。
与对照组相比，胶质瘤患者的DTI-ALPS指数显著降低（1.266±0.258 vs. 1.395±0.174，p<0.001），脑脊液体积更大（174.53±34.89cm³ vs. 154.25±20.89cm³，p<0.001）。DTI-ALPS指数与肿瘤体积（r=-0.353，p<0.001）和PTBE体积（r=-0.266，p=0.015）呈负相关。高级别胶质瘤与较低的DTI-ALPS指数和较大的PTBE体积相关（所有p<0.001）。在多变量分析中，肿瘤分级是DTI-ALPS指数的独立预测因素（β=-0.244，p=0.011）。
胶质瘤与显著的类淋巴功能障碍有关，表现为DTI-ALPS指数降低以及脑脊液和PTBE体积增加。DTI-ALPS指数可作为胶质瘤患者类淋巴系统破坏的潜在生物标志物，为肿瘤相关的液体变化及脑肿瘤相互作用的病理生理学提供见解。
