DKI在高级别胶质瘤与单发脑转移瘤鉴别诊断的价值

发布时间：2019-04-12 19:47

【摘要】：目的初步探讨扩散峰度成像(DKI)技术在高级别胶质瘤(HGG)与单发脑转移瘤鉴别诊断的临床应用价值。方法对24例HGG及14例单发脑转移瘤患者术前行常规MRI扫描及DKI扫描,定量测定两组肿瘤实质区及瘤周水肿区的平均峰度(MK)值、各向异性(FA)值及平均扩散(MD)值,采用两样本t检验比较两组间各参数值有无差异,应用受试者工作特性(ROC)曲线确定最佳截断点并评估其鉴别两种疾病的敏感性及特异性。结果HGG与脑转移瘤肿瘤实质区MK、FA及MD值差异均无统计学意义(P0.05),两者瘤周水肿区FA值差异无统计学意义(P0.05),HGG瘤周水肿区MK值明显高于脑转移瘤(P=0.001,P0.05),而MD值明显低于脑转移瘤(P=0.011,P0.05)。ROC曲线分析,当瘤周水肿区MK值为0.488时,鉴别两种疾病的敏感性为75%,特异性为85.7%,MK值曲线下面积(AUC)为0.869;当瘤周水肿区MD值为1.849时,鉴别两种疾病的敏感性为85.7%,特异性仅为58.3%,MD值的AUC为0.741。结论 HGG与单发脑转移瘤瘤周水肿区的MD值及MK值有助于两者的鉴别,并且MK值的敏感性及特异性较高,DKI相比于扩散张量成像(DTI)可以为两种疾病的鉴别诊断提供更完整的信息。
[Abstract]:Objective to evaluate the clinical value of diffusion kurtography (DKI) in differential diagnosis of high grade glioma with (HGG) and single brain metastasis. Methods conventional MRI scan and DKI scan were performed in 24 patients with HGG and 14 patients with single brain metastasis before operation. The mean kurtosis (MK), anisotropic (FA) and average diffused (MD) were measured quantitatively in the parenchyma region and peritumor edema area of the two groups. Two-sample t-test was used to compare the difference of each parameter value between the two groups. The optimal cut-off point was determined by using the receiver operating characteristic (ROC) curve and its sensitivity and specificity for distinguishing the two diseases were evaluated. Results there was no significant difference in MK,FA and MD values between HGG and brain metastatic tumors (P0.05), while FA values in peritumor edema region were not significantly different between them (P0.05). The MK value in peritumor edema area of HGG was significantly higher than that in brain metastasis (P < 0. 001, P 0.05), while the MD value was significantly lower than that in brain metastasis (P < 0. 011, P 0. 05). Roc curve analysis showed that when the MK value of peritumor edema area was 0. 488, the MK value was significantly lower than that of brain metastasis tumor. The sensitivity and specificity of the two diseases were 75% and 85.7% respectively. The area (AUC) under the MK curve was 0.869. When the M D value of peritumor edema region was 1.849, the sensitivity was 85.7%, the specificity was only 58.3%, and the AUC of MD value was 0.741 1.The sensitivity and specificity were 85.7%, 58.3% and 0.741%, respectively. Conclusion the M D value and M K value of HGG and single brain metastatic tumors are helpful to differentiate them, and the sensitivity and specificity of M K values are high. Compared with diffusion Zhang Liang imaging (DTI), DKI can provide more complete information for differential diagnosis of the two diseases.
【作者单位】：山西医科大学医学影像学系;山西医科大学第一医院影像科;
【基金】：国家自然科学基金资助项目(基金编号81471652)
【分类号】：R739.41;R445.2

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