扩散加权成像ADC值直方图鉴别高级别胶质瘤与转移瘤的价值
发布时间：2018-04-03 19:45
本文选题：扩散加权成像 切入点：高级别胶质瘤 出处：《安徽医科大学》2017年硕士论文
【摘要】：目的探讨ADC直方图及其相关参数在鉴别高级别胶质瘤与脑转移瘤中的应用价值。材料与方法对未经过手术、化疗、放疗及其他抗肿瘤治疗的13例高级别胶质瘤和20例脑转移瘤行常规MR平扫、增强及DWI扫描(b=0,1000),将DWI扫描所重建出的ADC图,参照T2WI图像逐层勾画出肿瘤的边界,通过第三方软件生成整个瘤体的ADC直方图,并计算出直方图的平均值(ADCmean)、最大值(ADCmax)、最小值(ADCmin)、中位数(ADCmedian)、峰度、偏度、方差、极差和5th~95th百分位点之间每隔5个百分位点所测得的ADC值。比较高级别胶质瘤和脑转移瘤ADC直方图的各相关参数值之间的差异,P0.05的参数认为差异具有统计学意义,并通过ROC曲线评价各参数的诊断效能。结果高级别胶质瘤与脑转移瘤的ADC直方图均为频数分布不对称的偏态分布。高级别胶质瘤多为正偏态分布,高峰更为陡峭,通常呈“高狭峰”,右侧的尾部多延伸较长,明显长于左侧,ADC值大部分分布于左侧;脑转移瘤呈负偏态分布或正偏态分布,偏度一般小于高级别胶质瘤,呈“低阔峰”,左侧尾部多稍长于右侧,ADC值大多分布在右侧,且ADC值的分布较高级别胶质瘤集中。从统计结果看,高级别胶质瘤的峰度、偏度、ADCmax和极差分别为4.40±2.08、0.87±0.72、2.63±0.44×10-3mm2/s、2.14±0.52×10-3mm2/s,转移瘤的峰度、偏度、ADCmax和极差分别为3.12±1.44、0.41±0.55、2.17±0.65×10-3mm2/s、1.55±0.69×10-3mm2/s,转移瘤的以上四个参数值均低于高级别胶质瘤相应参数值,差异具有统计学意义(P0.05)。峰度系数的ROC曲线下面积为0.71,敏感度76.92%,特异度60%,其最佳阈值为2.87;偏度系数的ROC曲线下面积为0.72,敏感度53.85%,特异度90.00%,其最佳阈值为1.11;极差的ROC曲线下面积为0.76,敏感度84.62%,特异度65.00%,其最佳阈值为1.70×10-3mm2/s;ADCmax的ROC曲线下面积为0.70×10-3mm2/s,敏感度76.92%,特异度60.00%,最佳阈值为2.20×10-3mm2/s。极差的AUC和敏感度最好,偏度系数的特异度最好,两者联合特异度为58.50%,联合敏感度为92.90%,其联合敏感度高于单一参数的敏感度。结论ADC直方图在对高级别胶质瘤与脑转移瘤的鉴别中相对于常规ADC值测定具有一定的优势,可能成为有价值的新方法。
[Abstract]:Objective to evaluate the value of ADC histogram and its related parameters in differentiating high grade gliomas from brain metastases.Materials and methods 13 cases of high grade gliomas and 20 cases of brain metastases without operation, chemotherapy, radiotherapy and other antitumor therapy were examined by conventional Mr scan, enhanced Mr scan and DWI scan. ADC images were reconstructed by DWI scan.The ADC values measured at every five percentile points between the range and the 5th~95th percentile.Comparing the differences of ADC histogram parameters between high-grade gliomas and brain metastases, the difference was statistically significant, and the diagnostic efficacy of each parameter was evaluated by ROC curve.Results the ADC histograms of high grade gliomas and brain metastases were skewed with asymmetric frequency distribution.The high grade gliomas are mostly positive skew distribution, the peak is steeper, usually "high narrow peak", the right tail extension is longer, obviously longer than the left side ADC value distribution most of the left side, brain metastases show negative skew distribution or positive skew distribution.The degree of deviation is generally smaller than that of high grade gliomas, showing a "low broad peak". The value of ADC in the left tail is longer than that in the right, and the ADC value is concentrated in the higher grade gliomas.浠庣粺璁＄粨鏋滅湅,楂樼骇鍒兌璐ㄧ槫鐨勫嘲搴，
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