Quantitative analysis of permeability for glioma grading using dynamic contrast-enhanced magnetic resonance imaging.
Quantitative analysis of permeability for glioma grading using dynamic contrast-enhanced magnetic resonance imaging.
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DOI：
10.3892/ol.2017.6895
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发表时间：
2017-11
期刊：
影响因子：
2.9
通讯作者：
Fu K
中科院分区：
文献类型：
--
作者：
Zhao M;Guo LL;Huang N;Wu Q;Zhou L;Zhao H;Zhang J;Fu K
本研究的目的是定量分析肿瘤实体和瘤周水肿的渗透性胶质瘤分级，使用动态增强磁共振成像（DCE-MRI）。在本回顾性研究中，80例患者在2012年1月至2015年6月期间接受了3.0 T的T1加权DCE-MRI检查，并获得了病理结果（包括星形细胞瘤和少突胶质细胞瘤）。所有病例均经手术证实为I-IV级胶质瘤。原始DCE-MRI数据采用双室修正Tofts模型进行分析。根据肿瘤实体和瘤周水肿的最高渗透性区域选择感兴趣区域，计算前向体积传递常数（Ktranss）、反流率（kep）和体积分数（ve）。采用Bonferroni校正的方差分析比较不同级别胶质瘤实体和瘤周水肿的Ktranss、kep和ve值。本研究结果显示，Ktranss，kep和ve值在每个阶段与病理分级相关（r=0.951，0.804和0.766，分别）。Ktranss，kep中不同肿瘤等级之间存在显著差异，kep中II级和III级之间除外。此外，I/II级与III/IV级之间的ve差异有统计学意义。采用受试者算子特征曲线分析方法评价渗透率参数的诊断精度。Ktranss被证明对评估肿瘤分级具有最高的敏感性和特异性。Ktranss阈值分别为0.160、0.420和0.935时，可区分I级与II级、II级与III级和III级与IV级胶质瘤，敏感性分别为0.900、0.950和0.950，特异性分别为0.950、0.950和0.850。瘤周水肿的Ktranss、Kep和Ve值与胶质瘤病理分级相关（分别为Ktransr =0.438，P<0.001; Kep r=0.385，P<0.001; Ve r=0.397，P<0.001）。瘤周水肿的Ktranss值在低级别和高级别胶质瘤之间有显著差异。Ktranss诊断瘤周水肿的敏感性和特异性分别为0.975和0.950，阈值为0.007。因此，胶质瘤实体和瘤周水肿的Ktranss的DCE-MRI参数可用于准确区分胶质瘤的等级。
The objective of the present study was to quantitatively analyze the permeability of tumor entity and peritumor edema in glioma grading, using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). In the present retrospective study, 80 patients underwent T1-weighted DCE-MRI examination at 3.0 T and the pathological results (including astrocytoma and oligodendroglioma) were obtained between January 2012 and June 2015. All cases were surgically validated as grade I–IV gliomas. The original DCE-MRI data were analyzed using dual compartment modified Tofts model. The forward volume transfer constant (Ktrans), backflux rate (kep) and fractional volume (ve) were calculated with the region of interest selected on the highest permeability area of the tumor entity and peritumor edema. Analysis of variance with the Bonferroni correction was used to compare the values of Ktrans, kep, and ve of the tumor entity and peritumor edema in different glioma grades. The results of the present study revealed that the Ktrans, kep, and ve values in each stage were associated with the pathological grading (r=0.951, 0.804 and 0.766, respectively). There were significant differences identified between different tumor grades in Ktrans, kep, with the exception being between grades II and III in kep. In addition, there was a significant difference revealed between grade I/II and grade III/IV in ve. Receiver operator characteristics curve analysis was used to evaluate the diagnosis accuracies of permeability parameters. Ktrans was demonstrated to exhibit the highest sensitivity and specificity for evaluating the tumor grade. With the threshold values of 0.160, 0.420 and 0.935 in Ktrans on tumor, glioma grades I vs. II, II vs III and III vs. IV may be differentiated with sensitivities of 0.900, 0.950 and 0.950, and specificities of 0.950, 0.950 and 0.850, respectively. Furthermore, associations were observed between the Ktrans, kep and ve values of peritumor edema and the pathological grading in glioma (Ktrans r=0.438, P<0.001; Kep r=0.385, P<0.001; Ve r=0.397, P<0.001, respectively). Ktrans values in peritumoral edema revealed significant differences between low-grade and high-grade glioma. The sensitivity and specificity for Ktrans of peritumor edema were 0.975 and 0.950, with a threshold value of 0.007. Therefore, the DCE-MRI parameters of Ktrans of tumor entity and peritumor edema in gliomas may be used to accurately differentiate glioma grades.
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