Grading of Gliomas by Using Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MR Imaging and Diffusion Kurtosis MR Imaging
Grading of Gliomas by Using Monoexponential, Biexponential, and Stretched Exponential Diffusion-weighted MR Imaging and Diffusion Kurtosis MR Imaging
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DOI：
10.1148/radiol.2015142173
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发表时间：
2016-02-01
期刊：
影响因子：
19.7
通讯作者：
Wang, Meiyun
中科院分区：
文献类型：
--
作者：
Bai, Yan;Lin, Yusong;Wang, Meiyun
目的：定量比较从单指数，双指数和拉伸指数扩散加权成像模型和扩散峰度成像在胶质瘤分级中获得的各种扩散参数的潜力。材料和方法：本研究经当地伦理委员会批准，并获得所有受试者的书面知情同意书。应用3T磁共振成像仪对69例经病理证实的脑胶质瘤患者进行弥散加权成像和弥散峰度成像。采用双指数模型，从弥散加权图像计算各向同性表观弥散系数（ADC）、真ADC、假ADC和灌注分数。水分子扩散不均匀性指数和分布扩散系数计算扩散加权图像通过使用拉伸指数模型。从扩散峰度图像计算平均扩散率、各向异性分数和平均峰度。所有的数值都通过Mann-Whitney U检验在高级别和低级别胶质瘤之间进行比较。结果：高级别胶质瘤的ADC值、真ADC值、灌注分数、水分子弥散异质性指数、弥散分布系数和平均弥散度值均显著低于低级别胶质瘤（U = 109、56、129、6、206和229; P <.05）。高级别胶质瘤的伪ADC值和平均峰度值显著高于低级别胶质瘤（U = 98和8，分别为P <0.05）。水分子扩散非均匀性指数（受试者工作特征曲线下面积[AUC]= 0.993）和平均峰度（AUC = 0.991）的AUC值显著大于ADC（AUC = 0.866），平均扩散率（AUC = 0.722）和各向异性分数（AUC = 0.500）在区分低级别和高级别胶质瘤中的作用结论：水分子弥散异质性指数和平均峰度值与常规弥散参数相比，可提供胶质瘤的更多信息，并可改善胶质瘤的分级。(C)RSNA，2015年
Purpose: To quantitatively compare the potential of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging models and diffusion kurtosis imaging in the grading of gliomas.Materials and Methods: This study was approved by the local ethics committee, and written informed consent was obtained from all subjects. Both diffusion-weighted imaging and diffusion kurtosis imaging were performed in 69 patients with pathologically proven gliomas by using a 3-T magnetic resonance (MR) imaging unit. An isotropic apparent diffusion coefficient (ADC), true ADC, pseudoADC, and perfusion fraction were calculated from diffusionweighted images by using a biexponential model. A water molecular diffusion heterogeneity index and distributed diffusion coefficient were calculated from diffusion-weighted images by using a stretched exponential model. Mean diffusivity, fractional anisotropy, and mean kurtosis were calculated from diffusion kurtosis images. All values were compared between high-grade and low-grade gliomas by using a Mann-Whitney U test. Receiver operating characteristic and Spearman rank correlation analysis were used for statistical evaluations.Results: ADC, true ADC, perfusion fraction, water molecular diffusion heterogeneity index, distributed diffusion coefficient, and mean diffusivity values were significantly lower in high-grade gliomas than in low-grade gliomas (U = 109, 56, 129, 6, 206, and 229, respectively; P < .05). Pseudo-ADC and mean kurtosis values were significantly higher in high-grade gliomas than in low-grade gliomas (U = 98 and 8, respectively; P < .05). Both water molecular diffusion heterogeneity index (area under the receiver operating characteristic curve [AUC] = 0.993) and mean kurtosis (AUC = 0.991) had significantly greater AUC values than ADC (AUC = 0.866), mean diffusivity (AUC = 0.722), and fractional anisotropy (AUC = 0.500) in the differentiation of low-grade and high-grade gliomas (P < .05).Conclusion: Water molecular diffusion heterogeneity index and mean kurtosis values may provide additional information and improve the grading of gliomas compared with conventional diffusion parameters. (C) RSNA, 2015