合成MRI及弥散张量成像评估成人胶质瘤级别与异柠檬酸脱氢酶-1状态

目的 观察合成MRI(SynMRI)及弥散张量成像(DTI)评估成人胶质瘤级别与异柠檬酸脱氢酶-1(IDH-1)状态的价值。方法 回顾性分析115例成人胶质瘤患者,根据WHO分类将其分为成人低级别胶质瘤(aLGG)组(n=44)及成人高级别胶质瘤(aHGG)组(n=71);aLGG组含30例IDH-1突变型、2例野生型及12例无法确定,aHGG组依次为26例、24例及21例。比较组间SynMRI及DTI参数,包括T1值、T2值、质子密度(PD)、表观弥散系数(ADC)及各向异性分数(FA),分析其鉴别aLGG与aHGG、IDH-1突变型与野生型的效能。结果 组间及aHGG组内IDH-1突变型与野生型的T1值、T2值、ADC及FA差异均有统计学意义(P均＜0.05);以上述参数鉴别aLGG与aHGG的曲线下面积(AUC)分别为0.731、0.686、0.930及0.710,鉴别aHGG组内IDH-1突变型与野生型的AUC分别为0.775、0.729、0.817及0.705,均以ADC的AUC最高(P均＜0.05)。结论 T1值、T2值、ADC及FA等SynMRI和DTI参数均有助于鉴别aLGG与aHGG、IDH-1突变型与野生型,尤以ADC效能最高。

Synthetic MRI and diffusion tensor imaging for evaluating grade and isocitrate dehydrogenase-1 status of adult gliomas

Objective To observe the value of synthetic MRI (SynMRI) and diffusion tensor imaging (DTI) for evaluating grade and isocitrate dehydrogenase-1 (IDH-1) status of adult gliomas. Methods Totally 115 patients with adult glioma were retrospectively enrolled and divided into adult low-grade glioma (aLGG) group (n=44) and adult high-grade glioma (aHGG) group (n=71) according to WHO classification. There were 30 cases of IDH-1 mutant type, 2 cases of wild type and 12 cases of undetermined gliomas in aLGG group, whereas 26 cases of IDH-1 mutant type, 24 cases of wild type and 21 cases undetermined gliomas in aHGG group, respectively. SynMRI and DTI parameters, including T1 value, T2 value, proton density (PD), apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were compared between groups, and the efficacy of each parameter for distinguishing aLGG and aHGG, as well as IDH-1 mutant type and wild type was analyzed. Results Significant differences of T1 value, T2 value, ADC and FA were found between groups, also between IDH-1 mutant type and wild type gliomas within aHGG group (all P＜0.05). The area under the curve (AUC) of the above parameters for distinguishing aLGG and aHGG was 0.731, 0.686, 0.930 and 0.710, respectively, while for distinguishing IDH-1 mutant type and wild type in aHGG group was 0.775, 0.729, 0.817 and 0.705, respectively, among which ADC had the highest AUC (all P＜0.05). Conclusion SynMRI and DTI parameters such as T1 value, T2 value, ADC and FA were helpful for distinguishing aLGG and aHGG, IDH-1 mutant type and wild type, among which ADC had the highest efficacy.