摘要
目的 探讨磁共振成像(MRI)影像组学在胶质瘤术前分级评估中的应用价值。方法 回顾性分析2017年6月~2020年6月在本院接受手术治疗的胶质瘤患者50例,根据中枢神经系统肿瘤病理学将患者分为低级别胶质瘤组(Ⅰ~Ⅱ级)23例和高级别胶质瘤组(Ⅲ~Ⅳ级)27例。两组均行弥散加权成像(DWI)扫描和横向T;流体衰减反转恢复序列(T;FLAIR)定量分析,观察其影像特征。比较两组信号强度计算弥散系数(ADC)、分布扩散系数(DDC)和拉伸因子(α);以组织病理学作为“金标准”,计算DWI、T;FLAIR单独诊断及联合诊断胶质瘤分级的价值;绘制受试者操作特性(ROC)曲线,计算曲线下面积(AUC)。结果 本研究共纳入胶质瘤患者50例,其中低级别胶质瘤23例,高级别胶质瘤27例;在DWI和T;FLAIR检查中,高级别胶质瘤组ADC、DDC和α值均明显低于低级别胶质瘤组(P<0.05);DWI诊断敏感度、准确度为77.78%、76.00%(Kappa=0.517);T;FLAIR诊断敏感度、准确度为8 8.8 9%、84.00%(Kappa=0.676);DWI联合T;FLAIR诊断敏感度、准确度为96.29%、90.00%(Kappa=0.796);DWI、T;FLAIR诊断胶质瘤分级的AUC分别为0.758和0.836,DWI联合T;FLAIR诊断胶质瘤分级的AUC为0.895(P<0.05)。结论 MRI影像学组在鉴别高、低级别胶质瘤方面具有较高的诊断价值。
Objective To explore the application value of magnetic resonance imaging(MRI) radiomics in assessing the preoperative grading of glioma. Methods A retrospective analysis was performed on the 50patients with glioma undergoing surgical treatment in the hospital between June 2017 and June 2020. According to the pathology of central nervous system tumors, they were divided into lowgrade glioma group(grade Ⅰ-Ⅱ, 23 cases) and high-grade glioma group(grade Ⅲ-Ⅳ, 27 cases). All underwent diffusion-weighted imaging(DWI) scan and quantitative analysis of transverse T;fluidattenuated inversion recovery(T;FLAIR) to observe imaging characteristics. The signal intensities between the two groups were compared to calculate apparent diffusion coefficient(ADC), distribution diffusion coefficient(DDC) and stretch factor(α). Taking histopathology as the "golden standard",diagnostic value of DWI, T;FLAIR and combined detection for glioma grading was calculated. The receiver operating characteristic(ROC) curves were drawn and the area under the curve(AUC) was calculated. Results In the 50 patients with glioma, there were 23 cases with low-grade gliomas and 27 cases with high-grade gliomas. In DWI and T;FLAIR examinations, ADC, DDC and α values in highgrade glioma group were all significantly lower than those in low-grade glioma group(P<0.05). The diagnostic sensitivity and accuracy of DWI, T;FLAIR and combined detection were [77.78%, 76.00%(Kappa=0.517)], [88.89%, 84.00%(Kappa=0.676)] and [96.29%, 90.00%(Kappa=0.796)], respectively.AUC values of WI, T;FLAIR and combined detection in the diagnosis of glioma grading were 0.758, 0.836and 0.895(P<0.05). Conclusion MRI radiomics is of great value in the differential diagnosis of highgrade and low-grade gliomas.
作者
张昌飞
杜福川
张昌凯
ZHANG Chang-fei;DU Fu-chuan;ZHANG Chang-kai(Department of Radiology,Hainan Hospital of traditional Chinese Medicine,Haikou 570203,Hainan Province,China)
出处
《中国CT和MRI杂志》
2022年第5期16-19,共4页
Chinese Journal of CT and MRI
关键词
磁共振成像
影像组学
弥散加权成像
胶质瘤
术前分级评估
Magnetic Resonance Imaging
Radiomics
Diffusion Weighted Imaging
Glioma
Preoperative Grading Assessment
