联合DKI、FW-DTI及MAP-MRI预测成人弥漫性胶质瘤1p/19q共缺失OA
Prediction of 1p/19q co-deletion in adult diffuse glioma using combined DKI,FW-DTI,and MAP-MRI
目的 探讨联合扩散峰度成像(diffusion kurtosis imaging,DKI)、自由水扩散张量成像(free water diffusion tensor imaging,FW-DTI)及平均表观传播子磁共振成像(mean apparent propagator magnetic resonance imaging,MAP-MRI)在预测成人弥漫性胶质瘤1p/19q共缺失中的价值.材料与方法 回顾性分析经手术病理证实的72例胶质瘤患者的临床、病理及影像资料.根据1p/19q的共缺失状态分为共缺失组(n=32)及未缺失组(n=40).术前行常规MRI及基于q空间的扩散谱成像(diffusion spectrum imaging,DSI),后处理获得DKI、FW-DTI及MAP-MRI的参数图.比较两组患者的临床特征、常规MRI表现及各扩散模型参数的差异.使用受试者工作特性(receiver operating characteristic,ROC)曲线评价各参数的在预测胶质瘤lp/19q共缺失中的价值,并计算曲线下面积(area under the curve,AUC).结果 两组MRI表现中,肿瘤境界不清楚存在差异,而其他临床特征及MRI表现差异无统计学意义.1p/19q共缺失组胶质瘤的平均峰度(mean kurtosis,MK)、细胞外自由水分数(extracellular free water fraction,FWF)、细胞外水分子返回原点概率(extracellular water molecule return-to-origin probability,RTOP)及非高斯分布指数(non-Gaussian index,NG)值高于未缺失组(t值分别为4.913,4.376,3.761及6.916,P＜0.05),而自由水校正各向异性分数(free water-corrected anisotropy fraction,FW-FA)及 q空间逆方差(q-space inverse variance,QIV)值则低于未缺失组(t值分别为2.945及3.761,P＜0.05),其他参数之间差异无统计学意义(P＞0.05).联合MK、FWF及NG对胶质瘤1p/19q共缺失预测的AUC值为0.935,敏感度为85.00％,特异度为93.75％.结论 联合DKI、FW-DTI及MAP-MRI多参数分析可术前预测胶质瘤1p/19q共缺失的状态,可协助临床制订个体化的治疗方案.
Objective:To investigate the value of combined diffusion kurtosis imaging(DKI),free water diffusion tensor imaging(FW-DTI),and mean apparent propagator magnetic resonance imaging(MAP-MRI)in predicting 1p/19q co-deletion in adult diffuse gliomas.Materials and Methods:Clinical,pathological,and imaging features from 72 glioma patients with surgically confirmed pathology were retrospectively analyzed.Patients were categorized into the co-deletion group(n=32)and non-co-deletion group(n=40)based on 1p/19q co-deletion status.Preoperative conventional MRI and q-space diffusion spectrum imaging(DSI)were performed,with post-processing generating DKI,FW-DTI,and MAP-MRI parameter maps.Clinical characteristics,conventional MRI features,and differences in diffusion model parameters were compared between groups.Receiver operating characteristic(ROC)curves were utilized to evaluate the predictive value of each parameter for 1p/19q co-deletion in gliomas,with area under curve(AUC)values calculated.Results:Among MRI features,tumor margin indistinctness differed significantly between groups,while other clinical characteristics and MRI features showed no statistically differences.The 1p/19q-deleted group exhibited higher mean kurtosis(MK),extracellular free water fraction(FWF),extracellular water molecule retum-to-origin probability(RTOP),and non-Gaussian index(NG)values compared to the non-deleted group(t-values were 4.913,4.376,3.761,and 6.916,respectively,with P＜0.05.).Conversely,the free water-corrected anisotropy fraction(FW-FA)and q-space inverse variance(QIV)values were lower in the deleted group(t-values were 2.945 and 3.761,with P＜0.05).No statistically significant differences were observed in other parameters(P＞0.05).The combined AUC value for predicting 1p/19q co-deletion using MK,FWF,and NG was 0.935,with a sensitivity of 85.00％and specificity of 93.75％.Conclusions:The combination of DKI,FW-DTI,and MAP-MRI can predict the status of 1p/19q co-deletion in gliomas preoperatively,facilitating the development of individualized treatment plans.
曲源;田慧;张旭;李贤军
西安交通大学第一附属医院医学影像科,西安 710061||新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐 830000新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐 830000新疆维吾尔自治区人民医院放射影像中心,乌鲁木齐 830000西安交通大学第一附属医院医学影像科,西安 710061
医药卫生
胶质瘤1p/19q共缺失磁共振成像扩散峰度成像自由水扩散张量成像平均表观传播子
glioma1p/19q co-deletionmagnetic resonance imagingdiffusion kurtosis imagingfree water diffusion tensor imagingmean apparent propagator
《磁共振成像》 2026 (4)
56-61,6
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