Prognostic value of perfusion MR imaging of high-grade astrocytomas: Long-term follow-up study
Prognostic value of perfusion MR imaging of high-grade astrocytomas: Long-term follow-up study
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DOI：
10.3174/ajnr.a1121
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发表时间：
2008-09-01
影响因子：
3.5
通讯作者：
Yamashita, Y.
中科院分区：
文献类型：
--
作者：
Hirai, T.;Murakami, R.;Yamashita, Y.
背景和目的：虽然灌注磁共振成像在各种胶质瘤的预后价值已被调查，在高级别星形细胞瘤单独尚未得到充分评价。本研究的目的是回顾性评估术前灌注MRI上肿瘤最大相对脑血容量（rCBV）是否对高级别星形细胞瘤患者的预后有价值。（30名男性，19名女性;年龄范围，23-76岁）幕上高级别星形细胞瘤患者在治疗开始前接受了MR成像。对患者年龄、性别、症状持续时间、神经功能、精神状态、Karnofsky行为量表、手术范围、组织病理学诊断、肿瘤成分增强和最大rCBV进行评估，以确定影响生存的因素。Kaplan-Meier生存曲线、logrank检验和多变量考克斯比例风险模型用于评估预后因素。结果：31例多形性胶质母细胞瘤患者的最大rCBV显著高于18例间变性星形细胞瘤患者（P <0.03）。27例最大rCBV值较低（2.3）的患者的2年总生存率为67%（P < .001）。独立的重要预后因素是组织学诊断（风险比= 9.707; 95%置信区间（CI），3.163-29.788），最大rCBV（4.739; 95% CI，1.950-11.518），手术范围（2.692; 95% CI，1.196-6.061），和性别（2.632; 95% CI，1.153-6.010）。结论：治疗前MR灌注成像的最大rCBV是高级别星形细胞瘤患者生存的有用临床预后生物标志物。
BACKGROUND AND PURPOSE: Although the prognostic value of perfusion MR imaging in various gliomas has been investigated, that in high-grade astrocytomas alone has not been fully evaluated. The purpose of this study was to evaluate retrospectively whether the tumor maximum relative cerebral blood volume (rCBV) on pretreatment perfusion MR imaging is of prognostic value in patients with high-grade astrocytoma.MATERIALS AND METHODS: Between January 1999 and December 2002, 49 patients (30 men, 19 women; age range, 23-76 years) with supratentorial high-grade astrocytoma underwent MR imaging before the inception of treatment. The patient age, sex, symptom duration, neurologic function, mental status, Karnofsky Performance Scale, extent of surgery, histopathologic diagnosis, tumor component enhancement, and maximum rCBV were assessed to identify factors affecting survival. Kaplan-Meier survival curves, the logrank test, and the multivariate Cox proportional hazards model were used to evaluate prognostic factors.RESULTS: The maximum rCBV was significantly higher in the 31 patients with glioblastoma multiforme than in the 18 with anaplastic astrocytoma (P < .03). The 2-year overall survival rate was 67% for 27 patients with a low ( 2.3) maximum rCBV value (P < .001). Independent important prognostic factors were the histologic diagnosis (hazard ratio = 9.707; 95% confidence interval (CI), 3.163-29.788), maximum rCBV (4.739; 95% CI, 1.950-11.518), extent of surgery (2.692; 95% CI, 1.196-6.061), and sex (2.632; 95% CI, 1.153-6.010).CONCLUSION: The maximum rCBV at pretreatment perfusion MR imaging is a useful clinical prognostic biomarker for survival in patients with high-grade astrocytoma.