Chen Ting, Wang Peipei, Gao Eryuan, Bai Jie, Zhao Guohua, Zhao Kai, Zhao Gaoyang, Zhang Yu, Zhang Yong, Wang Mengzhu, Yang Guang, Xu Boyan, Ma Xiaoyue, Cheng Jingliang
Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.
MR Research Collaboration, Siemens Healthineers Ltd., Beijing, China.
Front Neurosci. 2025 Jul 28;19:1605786. doi: 10.3389/fnins.2025.1605786. eCollection 2025.
This study aimed to evaluate the efficacy of diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and mean apparent propagator-magnetic resonance imaging (MAP-MRI) in detecting CST injury caused by GBM and to compare their performances.
We enrolled 76 patients diagnosed with GBM with motor weakness (MW, = 22) or normal motor (NM, = 54). Bilateral CSTs were reconstructed, and a comparative analysis of diffusion parameters was performed based on four imaging models between affected and healthy sides. Relative diffusion parameters were assessed in the MW and NM groups. Statistical analyses were performed using SPSS software.
Significant alterations in most diffusion parameters of DTI, DKI, NODDI, and MAP-MRI were observed in the affected CST group compared to the healthy CST group ( < 0.05). Notable differences in the relative diffusion parameters were observed between the MW and NW groups across all four imaging models ( < 0.05). Specifically, DKI-based relative mean kurtosis (MK) exhibited a higher area under the curve (0.813), demonstrating greater sensitivity and specificity, which significantly positively correlated with muscle strength. DeLongs test revealed a significant performance difference between DKI and DTI.
Diffusion parameters from DTI, DKI, NODDI, and MAP-MRI are useful for evaluating CST injury. While DKI-derived MK and NODDI-derived ICVF achieved identical high AUC values, MK exhibited a more balanced sensitivity-specificity profile for assessing microstructural alterations in CST injury, this advantage of DKI may better address clinical demands, potentially aiding in surgical planning and preserving motor function in patients with GBM.
本研究旨在评估扩散张量成像（DTI）、扩散峰度成像（DKI）、神经突方向离散度与密度成像（NODDI）以及平均表观传播者磁共振成像（MAP-MRI）在检测胶质母细胞瘤（GBM）所致皮质脊髓束（CST）损伤中的效能，并比较它们的性能。
我们纳入了76例被诊断为GBM且伴有运动无力（MW，n = 22）或运动正常（NM，n = 54）的患者。重建双侧CST，并基于四种成像模型对患侧和健侧之间的扩散参数进行比较分析。在MW组和NM组中评估相对扩散参数。使用SPSS软件进行统计分析。
与健康CST组相比，在受影响的CST组中观察到DTI、DKI、NODDI和MAP-MRI的大多数扩散参数有显著改变（P < 0.05）。在所有四种成像模型中，MW组和NW组之间的相对扩散参数存在显著差异（P < 0.05）。具体而言，基于DKI的相对平均峰度（MK）的曲线下面积较高（0.813），显示出更高的敏感性和特异性，且与肌肉力量显著正相关。DeLong检验显示DKI和DTI之间存在显著的性能差异。
DTI、DKI、NODDI和MAP-MRI的扩散参数可用于评估CST损伤。虽然基于DKI的MK和基于NODDI的各向同性体积分数（ICVF）获得了相同的高曲线下面积值，但MK在评估CST损伤的微观结构改变方面表现出更平衡的敏感性-特异性特征，DKI的这一优势可能更好地满足临床需求，潜在地有助于GBM患者的手术规划和运动功能保留。
