体素内不相干运动成像无创性诊断脑胶质细胞瘤异柠檬酸盐脱氢酶1基因的初步研究

发布时间：2018-05-16 04:13

本文选题：体素内不相干运动成像 + 异柠檬酸盐脱氢酶基因　；参考：《上海医学》2017年09期

【摘要】：目的探讨体素内不相干运动成像(IVIM)无创性诊断弥漫性胶质细胞瘤异柠檬酸盐脱氢酶1(IDH1)基因状态的价值。方法前瞻性收集95例弥漫性胶质细胞瘤患者的临床资料,测量肿瘤实性区域IVIM的各影像学参数:灌注比例系数(F)、平均表观扩散系数(ADCmean)、快速表观扩散系数(fastADC)、扩散系数(DDC)、伪扩散系数(D*)。计算以对侧脑白质区标化后的参数:相对灌注比例系数(nrF)、相对平均表观扩散系数(nrADCmean)、相对快速表观扩散系数(nrfastADC)、相对扩散系数(nrDDC)、相对伪扩散系数(nrD*)。随访所有入组患者的病理学诊断和IDH1基因检查结果。采用独立样本t检验统计分析同级别IDH1基因野生型与突变型各参数差异,有效参数绘制ROC曲线,同时应用Logistics回归分析计算IDH1基因整体正确预测率。结果突变型低级别组的F值、ADCmean值、nrADCmean值、DDC值均显著高于野生型低级别组(P值均0.05),两组间nrF值、D*值、nrD*值、nrDDC值、fastADC值、nrfastADC值的差异均无统计学意义(P值均0.05)。突变型高级别组的F值、fastADC值均显著低于野生型高级别组(P值均0.05),两组间nrF值、ADCmean值、nrADCmean值、D*值、nrD*值、DDC值、nrDDC值、nrfastADC值的差异均无统计学意义(P值均0.05)。低级别胶质细胞瘤患者F的切值、敏感度、特异度、ROC曲线的AUC分别为0.125、0.667、0.625、0.780,ADCmean值分别为1.182、0.750、0.875、0.842,nrADCmean值分别为1.481、0.762、0.875、0.899,DDC值分别为1.193、0.792、0.750、0.774。高级别胶质细胞瘤患者F的切值、敏感度、特异度、ROC曲线的AUC分别为0.155、0.750、0.750、0.775,fastADC值分别为1.545、0.708、0.875、0.813。低级别胶质细胞瘤联合F值和nrADCmean值得出诊断IDH1基因的整体正确预测率为93.8%,似然比为13.97。高级别胶质细胞瘤联合F值和fastADC值得出诊断IDH1基因的整体正确预测率为82.5%,似然比为46.07。结论 IVIM检查为术前无创性诊断弥漫胶质细胞瘤IDH1基因状态提供了新的方法。
[Abstract]:Objective to investigate the value of voxel incoherent motion imaging (IVIMI) in noninvasive diagnosis of isocitrate dehydrogenase (IDH1) gene status in diffuse glioma. Methods the clinical data of 95 patients with diffuse glioma were collected prospectively. The imaging parameters of IVIM in solid tumor region were measured as follows: perfusion ratio coefficient, mean apparent diffusion coefficient, fast apparent diffusion coefficient and pseudo-diffusion coefficient. The normalized parameters of the contralateral white matter area were calculated as follows: relative perfusion ratio coefficient nrFU, relative average apparent diffusion coefficient nrADCmean, relative fast apparent diffusion coefficient nrfast ADCC, relative diffusion coefficient nrDDCI, relative pseudo-diffusion coefficient nrDCU. All patients were followed up with pathological diagnosis and IDH1 gene examination. The differences between the wild type and mutation type of IDH1 gene of the same class were statistically analyzed by t-test of independent samples. The effective parameters were plotted to draw the ROC curve, and the overall correct prediction rate of IDH1 gene was calculated by Logistics regression analysis. Results the F value and the mean value of nrADCmean of mutation type low grade group were significantly higher than those of wild type low grade group (P < 0.05). There was no significant difference between the two groups in nrF value and nrDDC value and fast ADC value and nrfast ADC value (P < 0.05). The F value and fast ADC value of mutant high grade group were significantly lower than that of wild type high grade group (P < 0.05). There was no significant difference between two groups in terms of nrF value and nrDDC value, nrDDC value and nrDDC value respectively (P < 0.05). The AUC values of F, sensitivity and specificity in patients with low grade glioma were 0.125U 0.667U 0.6250.0.780 ADCmean, respectively 1.182nrA0.8750.8750.8750.899DDC was 1.193nrA0.792nrADCmean was 0.7740.0.792nrADCmean was 1.481nrA0.8750.899DDC was 1.193nrA0.792nrADCmean of 0.792nrA0.774, respectively. The AUC values of F, sensitivity, specificity and ROC curves of patients with high grade glioma were 0.155, 0.750, 0.750 and 0.775A, respectively. The values of fast ADC were 1.545U 0.708U 0.875n 0.813, respectively. The overall correct prediction rate of low grade glioma combined with F value and nrADCmean is 93. 8% and the likelihood ratio is 13. 97%. High grade glioma combined with F value and fastADC is worthy of diagnosing IDH1 gene. The overall correct prediction rate is 82.5 and the likelihood ratio is 46.07. Conclusion IVIM provides a new method for noninvasive preoperative diagnosis of IDH1 gene status in diffuse glioma.
【作者单位】：复旦大学附属华山医院放射科复旦大学医学功能与分子影像研究所;复旦大学附属肿瘤医院放射科;复旦大学附属华山医院病理科;
【基金】：国家自然科学基金(81471627)、国家自然科学基金青年项目(81660285)资助上海市科学技术委员会合作项目(16410722800)
【分类号】：R445.2;R739.41

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