A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas
A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas
复制标题
DOI：
10.3174/ajnr.a0674
复制
发表时间：
2007-10-01
影响因子：
3.5
通讯作者：
Kim, S. Y.
中科院分区：
文献类型：
--
作者：
Kim, H. S.;Kim, S. Y.
背景和目的：本研究的目的是确定是否与脉冲动脉自旋标记（PASL）和表观扩散系数ADC）获得的定性和定量的措施，提高胶质瘤分级相比，传统的MR images.Materials和方法：我们前瞻性地进行了2个定性的共识审查33个疑似胶质瘤：1）传统的MR图像单独和2）传统的MR图像与PASL和ADC。为了计算PASL和ADC的诊断性能参数，我们使用基于肿瘤灌注信号强度（sTP）和视觉ADC评分（sADC）的定性评分系统。然后，我们分析了感兴趣的定量区域，并计算了最大肿瘤灌注信号强度的比率。结果：两名观察员在第一次复查时对33个病灶中的23个（70%）进行了准确的肿瘤分级，在第二次复查时对33个病灶中的29个（88%）进行了准确的肿瘤分级。联合sTP和sADC评分确定胶质瘤分级的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为90.9%、90.9%、95.2%和83.3%。统计分析得出rTPmax的阈值为1.24，mADC的阈值为0.98 x 10（-1）mm/s（2），灵敏度、特异性、PPV和NPV分别为95.5%、81.8%、91.3%和90.1%，以及90.9%、81.8%、90.9%和81.8%。受试者工作特征曲线分析显示定量和联合定性参数之间无显著性差异。结论：PASL和ADC与常规成像相比，可显著提高胶质瘤分级诊断的准确性。
Background and Purpose: The purpose of this study was to determine whether qualitative and quantitative measures obtained with pulsed arterial spin-labeling (PASL) and apparent diffusion coefficients ADC) improve glioma grading compared with conventional MR images.Materials and Methods: We prospectively performed 2 qualitative consensus reviews in 33 suspected gliomas: 1) conventional MR images alone and 2) conventional MR images with PASL and ADC. To calculate the diagnostic performance parameters of PASL and ADC, we used a qualitative scoring system on the basis of the tumor perfusion signal intensity (sTP) and visual ADC scoring (sADC). We then analyzed quantitative regions of interest and calculated the ratio of the maximum tumor perfusion signal intensity. (rTPmax) and the minimum ADC value (mADC).Results: Two observers diagnosed accurate tumor grades in 23 of 33 (70%) lesions in the first review and in 29 of 33 (88%) lesions in the second review. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for determining a glioma grading by using combined sTP and sADC scoring were 90.9, 90.9, 95.2, and 83.3%, respectively. Statistical analysis gave a threshold value of 1.24 for rTPmax and 0.98 x 10(-1) mm/s(2) for mADC to provide a sensitivity, specificity, PPV, and NPV of 95.5, 81.8, 91.3, and 90.1% and 90.9, 81.8, 90.9, and 81.8%, respectively. The receiver operator characteristic curve analyses showed no significant difference between the quantitative and combined qualitative parameters.Conclusion: PASL and ADC significantly improve the diagnostic accuracy of glioma grading compared with conventional imaging.