Grading of Glioma: combined diagnostic value of amide proton transfer weighted, arterial spin labeling and diffusion weighted magnetic resonance imaging
Grading of Glioma: combined diagnostic value of amide proton transfer weighted, arterial spin labeling and diffusion weighted magnetic resonance imaging
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DOI：
10.1186/s12880-020-00450-x
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发表时间：
2020-05-14
影响因子：
2.7
通讯作者：
Guo, Fan
中科院分区：
文献类型：
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作者：
Kang, Xiao-wei;Xi, Yi-bin;Guo, Fan
背景：探讨酰胺质子转移(APT)加权磁共振成像(MRI)、动脉自旋标记(ASL)、弥散加权成像(DWI)及其联合应用对高级别和低级别胶质瘤(LGG)的鉴别诊断价值。方法采用3.0T磁共振扫描仪对27例患者进行常规、APT、ASL和DWI扫描，其中9例为LGG，18例为HGG。对HGG和LGG的平均表观扩散系数(ADC Mean)、20%ADC(ADC 20th)、平均APT(APT Mean)、90%ACT(APT 90th)、相对平均脑血流量(RCBF Mean)和相对90%CBF(RCBF90th)等定量参数进行比较。通过对各参数及其组合的受试者工作特性(ROC)分析来评价诊断性能。分析MRI各参数与Ki-67的相关性。结果HGG组APT值显著高于LGG组(P<；0.005)，ADC值显著低于LGG组(P<；0.0001)。ADC20和APT均值较其他单项指标具有更高的判别能力，其ROC曲线下面积分别为0.877和0.840。加入ADC参数后，APT和rCBF的分辨能力显著提高。ADC值分别与APT、rCBF值呈负相关，APT值与rCBF值呈正相关。ADC值与Ki-67显著相关。结论APT和DWI对HGG和LGG的鉴别诊断有重要价值。APT、DWI和ASL联合应用可提高HGG与LGG的鉴别能力。
Background To investigate the ability of amide proton transfer (APT) weighted magnetic resonance imaging (MRI), arterial spin labeling (ASL), diffusion weighted imaging (DWI) and the combination for differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs). Methods Twenty-seven patients including nine LGGs and eighteen HGGs underwent conventional, APT, ASL and DWI MRI with a 3.0-T MR scanner. Histogram analyses was performed and quantitative parameters including mean apparent diffusion coefficient (ADC mean), 20th-percentile ADC (ADC 20th), mean APT (APT mean), 90th-percentile APT (APT 90th), relative mean cerebral blood flow (rCBF mean) and relative 90th-percentile CBF (rCBF 90th) were compared between HGGs and LGGs. The diagnostic performance was evaluated with receiver operating characteristic (ROC) analysis of each parameter and their combination. Correlations were analyzed among the MRI parameters and Ki-67. Results The APT values were significantly higher in the HGGs compared to the LGGs (p < 0.005), whereas ADC values were significantly lower in HGGs than LGGs (P < 0.0001). The ADC 20th and APT mean had higher discrimination abilities compared with other single parameters, with the area under the ROC curve (AUC) of 0.877 and 0.840. Adding ADC parameter, the discrimination ability of APT and rCBF significantly improved. The ADC was negatively correlated with the APT and rCBF value, respectively, while APT value was positively correlated with rCBF value. Significant correlations between ADC values and Ki-67 were also observed. Conclusions APT and DWI are valuable in differentiating HGGs from LGGs. The combination of APT, DWI and ASL imaging could improve the ability for discriminating HGGs from LGGs.