Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas: a multicenter study in Japan
Usefulness of perfusion- and diffusion-weighted imaging to differentiate between pilocytic astrocytomas and high-grade gliomas: a multicenter study in Japan
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灌注加权和弥散加权成像在区分毛细胞性星形细胞瘤和高级别胶质瘤方面的作用：日本的一项多中心研究
DOI：
10.1007/s00234-018-1991-7
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发表时间：
2018
期刊：
影响因子：
2.8
通讯作者：
Honda H
中科院分区：
文献类型：
--
作者：
Kikuchi K;Hiwatashi A;Togao O;Yamashita K;Kamei R;Kitajima M;Kanoto M;Takahashi H;Uchiyama Y;Harada M;Shinohara Y;Yoshiura T;Wakata Y;Honda H
目的毛细胞型星形细胞瘤（PA）的影像学表现多样，有时与高级别胶质瘤（HGG）相似。本研究旨在确定可用于区分PA和HGG的成像参数。MethodsAltogether，60例PA和138例HGG患者被纳入本研究。评价肿瘤性质和是否存在脑积水、瘤周水肿和播散。我们还测量了最大相对脑血流量（rCBFmax）和体积（rCBVmax），并确定了最小表观扩散系数（ADC min）在肿瘤的实体成分。评价相对T1（rT 1）、T2（rT 2）和对比增强T1（rCE-T1）强度值。使用Mann-WhitneyU检验比较PA和HGG之间的参数。受试者工作特征（ROC）曲线分析也被用来评估这些成像参数。P <0.05为显著性。结果10.0%的PA有瘤内出血，21.7%的PA有瘤内钙化。PA组rCBFmax和rCBVmax分别为0.50 ± 0.35，1.82 ± 1.21，显著低于HGG组（2.98 ± 1.80，9.54 ± 6.88）（P<0.0001，P = 0.0002）。PA的ADC最小值（1.36 ± 0.56 × 10− 3 mm 2/s）显著高于HGG（0.86 ± 0.37 × 10− 3 mm 2/s）（P< .0001）。ROC曲线分析显示rCBFmax的诊断价值最高。结论rCBFmax、rCBVmax和ADC最小值可用于区分PA和HGG。
PurposeImaging findings of pilocytic astrocytoma (PA) vary widely, sometimes resembling those of high-grade glioma (HGG). This study aimed to identify the imaging parameters that can be used to differentiate PA from HGG.MethodsAltogether, 60 patients with PAs and 138 patients with HGGs were included in the study. Tumor properties and the presence of hydrocephalus, peritumoral edema, and dissemination were evaluated. We also measured the maximum relative cerebral blood flow (rCBFmax) and volume (rCBVmax) and determined the minimum apparent diffusion coefficient (ADCmin) in the tumor’s solid components. The relative T1 (rT1), T2 (rT2), and contrast-enhanced T1 (rCE-T1) intensity values were evaluated. Parameters were compared between PAs and HGGs using the Mann–WhitneyUtest. Receiver operating characteristic (ROC) curve analysis was also used to evaluate these imaging parameters. A value ofP< .05 was considered to indicate significance.ResultsIntratumoral hemorrhage and calcification were observed in 10.0% and 21.7% of PAs, respectively. The rCBFmaxand rCBVmaxvalues were significantly lower in PAs (0.50 ± 0.35, 1.82 ± 1.21) than those in HGGs (2.98 ± 1.80, 9.54 ± 6.88) (P< .0001,P= .0002, respectively). The ADCminvalues were significantly higher in PAs (1.36 ± 0.56 × 10−3mm2/s) than those in HGGs (0.86 ± 0.37 × 10−3mm2/s) (P< .0001). ROC analysis showed that the best diagnostic performance was achieved with rCBFmax.ConclusionThe rCBFmax, rCBVmax, and ADCmincan differentiate PAs from HGGs.