Quantitative Evaluation of Diffusion and Dynamic Contrast-Enhanced MR in Tumor Parenchyma and Peritumoral Area for Distinction of Brain Tumors.
Quantitative Evaluation of Diffusion and Dynamic Contrast-Enhanced MR in Tumor Parenchyma and Peritumoral Area for Distinction of Brain Tumors.
复制标题
肿瘤实质和瘤周区域的扩散和动态增强磁共振定量评估用于区分脑肿瘤
DOI：
10.1371/journal.pone.0138573
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Chu JP
中科院分区：
文献类型：
--
作者：
Zhao J;Yang ZY;Luo BN;Yang JY;Chu JP
目的定量评价基于肿瘤实质（TP）和瘤周（PT）面积的MR扩散和动态增强参数对脑肿瘤分型的诊断价值。方法45例患者（男23例，女22例;平均年龄46岁）均行常规、DCE-MR及DWI检查。对于每个肿瘤，将10-15个感兴趣区域（ROI）手动放置在TP和PT区域上。计算ADC值和渗透性参数（Ktranss、Ve、Kep和iAUC），并评估其诊断效率。结果在TP中，所有渗透性参数和ADC值均能显著区分低、高级别胶质瘤（HGG）（p<0.001），其中Ve的诊断能力最高（iAUC：0.79，cut-off point：0.15），Ktranss和Kep对胶质瘤分级的敏感性和特异性最高（84%和89%）。而在PT区，仅Ktranss对胶质瘤分级有帮助（P = 0.009，cut-off point：0.03 min-1）。TP组原发性和转移性中枢神经系统淋巴瘤（PCNSL）的Ve和iAUC均显著高于HGG组（p<0.003）。此外，在PT区域，平均Ktranss（p≤0.004）可以区分PCNSL和HGG，ADC（p≤0.003）可以区分转移瘤和HGG。结论弥散和DCE-MR对TP和PT区ADC值和通透性的定量分析，尤其是DCE-MR对胶质瘤的分级和鉴别诊断有一定的参考价值。在这些肿瘤的鉴别诊断中，强烈建议联合应用它们。
Purpose To quantitatively evaluate the diagnostic efficiency of parameters from diffusion and dynamic contrast-enhanced MR which based on tumor parenchyma (TP) and peritumoral (PT) area in classification of brain tumors. Methods 45 patients (male: 23, female: 22; mean age: 46 y) were prospectively recruited and they underwent conventional, DCE-MR and DWI examination. With each tumor, 10–15 regions of interest (ROIs) were manually placed on TP and PT area. ADC and permeability parameters (Ktrans, Ve, Kep and iAUC) were calculated and their diagnostic efficiency was assessed. Results In TP, all permeability parameters and ADC value could significantly discriminate Low- from High grade gliomas (HGG) (p<0.001); among theses parameters, Ve demonstrated the highest diagnostic power (iAUC: 0.79, cut-off point: 0.15); the most sensitive and specific index for gliomas grading were Ktrans (84%) and Kep (89%). While, in PT area, only Ktrans could help in gliomas grading (P = 0.009, cut-off point: 0.03 min-1). Moreover, in TP, mean Ve and iAUC of primary central nervous system lymphoma (PCNSL) and metastases were significantly higher than that in HGG (p<0.003). Further, in PT area, mean Ktrans (p≤0.004) could discriminate PCNSL from HGG and ADC (p≤0.003) could differentiate metastases with HGG. Conclusions Quantitative ADC and permeability parameters from Diffusion and DCE-MR in TP and PT area, especially DCE-MR, can aid in gliomas grading and brain tumors discrimination. Their combined application is strongly recommended in the differential diagnosis of these tumor entities.