三维伪连续式动脉自旋标记及体素内不相干运动成像评估脑胶质瘤IDH1基因分型

目的 对比术前三维伪连续式动脉自旋标记(3D-pCASL)及体素内不相干运动成像(IVIM)术前判断脑胶质瘤异柠檬酸脱氢酶1(IDH1)基因分型的价值.方法 回顾性分析78例经病理证实且有IDH1基因检测结果脑胶质瘤患者的临床及术前3D-pCASL及IVIM资料,将患者分为IDH1野生组(野生组,n=51)及IDH1突...

Three-dimensional pseudo-continuous arterial spin labeling and intravoxel incoherent motion imaging in evaluating IDH1 genotyping of gliomas

Objective To compare the value of three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) and intra voxel incoherent motion imaging (IVIM) in preoperative identifying the genotyping of isocitrate dehydrogenase 1 (IDH1) of brain gliomas. Methods The clinical and preoperative 3D-pCASL and IVIM data of 78 patients with pathologically confirmed glioma and IDH1 immunohistochemical results were retrospectively analyzed. The patients were divided into IDH1 wild group (wild group,n=51) and IDH1 mutant group (mutant group,n=27). There were 41 cases of high-grade gliomas (HGG) and 10 of low-grade gliomas (LGG) in wild group, 11 HGG and 16 LGG in mutant group. The clinical data and 3D-pCASL parameters (maximum cerebral blood flow [CBF_max], relative CBF [rCBF]), IVIM parameters (minimum true diffusion coefficient [D_min], maximum pseudo diffusion coefficient [D^*_max] and perfusion fraction [f_max]) were compared between groups. Receiver operating characteristic (ROC) curves of parameters being statistically different between groups were drawn for predicting IDH1 mutation genotyping of gliomas, and the corresponding diagnostic efficacies were analyzed. Results There was no difference of gender between groups (P=0.970), while the age of patients in wild group was higher than those in mutant group (P=0.040). The proportion of HGG was higher in wild group than that mutant group (P<0.001). CBF_max and rCBF in wild group were higher than those in mutant group (both P<0.05), while D_min, D^*_max and f_max were no difference between groups (all P>0.05). The area under the curve (AUC) of CBF_max and rCBF for differential diagnosis of IDH1 wild and IDH1 mutant in glioma was 0.71 and 0.73, respectively. Taken 91.28 ml/(100 g·min) as the threshold of CBF_max,the sensitivity and specificity was 74.10% and 74.50%, respectively, while taken 1.53 as the threshold of rCBF, the sensitivity and specificity was 55.60% and 84.30%, respectively. Conclusion 3D-PCASL parameters CBF_max, rCBF had certain efficacy in preoperative predicting IDH1 genotyping of gliomas. The stabilities of IVIM parameters were not good, and their value needed to be further studied.