磁共振扩散加权成像对不同级别脑膜瘤的诊断价值分析
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中国科学技术大学附属第一医院(安徽省立医院)

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Analysis of the Diagnostic Value of Magnetic Resonance Diffusion-Weighted Imaging for Meningiomas of Different Grades
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the first affiliated hospital of ustc

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    摘要:

    目的 探讨磁共振扩散加权成像(DWI)对不同级别脑膜瘤的诊断价值,为脑膜瘤的术前评估和分级提供影像学依据。方法 回顾性分析2020 年4 月至2024 年2 月在中国科学技术大学附属第一医院(安徽省立医院)接受手术治疗并经病理确诊的80 例脑膜瘤患者的临床和影像学资料。根据2016 年WHO 中枢神经系统肿瘤分类标准,将患者分为低级别组(WHO Ⅰ级,40 例)和高级别组(WHO Ⅱ级和Ⅲ级,40 例)。所有患者均在术前1 周内接受3.0T MRI 扫描,包括常规序列和DWI 序列。测量肿瘤实质部分的平均表观扩散系数(ADCmean)、最小表观扩散系数(ADCmin)及对侧正常白质ADC 值。采用独立样本t 检验比较两组间差异,并使用ROC 曲线分析各ADC 参数对脑膜瘤分级的诊断效能。结果 ①低级别组和高级别组在ADCmean、ADCmin 和对侧正常白质ADC 值上均存在显著差异(P < 0.05)。低级别组的ADCmean、ADCmin 和对侧正常白质ADC 值均高于高级别组(t=2.037、2.586、2.795;P=0.045、0.012、0.007)。② ROC曲线分析显示,ADCmean、ADCmin、对侧正常白质ADC 及联合预测因子的曲线下面积(AUC)分别为0.637、0.659、0.690和0.767,均具有一定的诊断价值(P < 0.05)。③联合预测因子的诊断效能最佳,其特异度为0.850,约登指数为0.425,截断值为3.299。对侧正常白质ADC 值在敏感度方面表现最佳,为0.650。结论 磁共振扩散加权成像对脑膜瘤的术前分级具有重要的诊断价值。ADCmean、ADCmin 和对侧正常白质ADC 值可作为鉴别低级别和高级别脑膜瘤的影像学指标。联合应用这些参数可以提高诊断的准确性,为临床制订个体化治疗方案提供重要参考。

    Abstract:

    Objective To explore the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) for meningiomas of different grades, providing imaging evidence for preoperative assessment and grading of meningiomas. Methods A retrospective analysis was conducted on the clinical and imaging data of 80 patients with meningiomas who underwent surgical treatment and were pathologically confirmed in The First Affiliated Hospital of USTC (Anhui Provincial Hospital) from April 2020 to February 2024. According to the 2016 WHO classification of central nervous system tumors, patients were divided into a low-grade group (WHO grade Ⅰ, 40 cases) and a high-grade group (WHO grades Ⅱ and Ⅲ, 40 cases). All patients underwent 3.0T MRI scans within one week before surgery, including conventional sequences and DWI sequences. The mean apparent diffusion coefficient (ADCmean), minimum apparent diffusion coefficient (ADCmin), and ADC values of the contralateral white matter were measured. Independent sample t-tests were used to compare differences between the two groups, and ROC curve analysis was performed to evaluate the diagnostic efficiency of each ADC parameter for meningioma grading. Results ① Significant differences were found in ADCmean, ADCmin, and contralateral white matter ADC values between the low-grade and high-grade groups (P < 0.05). The low-grade group had higher ADCmean, ADCmin, and contralateral white matter ADC values than the high-grade group(t=2.037, 2.586, 2.795;P=0.045, 0.012, 0.007). ② ROC curve analysis showed that the area under the curve (AUC) for ADCmean, ADCmin, contralateral white matter ADC, and their combined predictive factors were 0.637, 0.659, 0.690, and 0.767, respectively, all demonstrating certain diagnostic value (P < 0.05). ③ The combined predictive factor showed the best diagnostic efficiency, with a specificity of 0.850, a Youden index of 0.425, and a cutoff value of 3.299. The contralateral white matter ADC demonstrated the best sensitivity, at 0.650. Conclusions Magnetic resonance diffusion-weighted imaging has significant diagnostic value for preoperative grading of meningiomas. ADCmean, ADCmin, and contralateral white matter ADC values can serve as imaging indicators to differentiate between low-grade and high-grade meningiomas. The combined application of these parameters can improve diagnostic accuracy and provide important references for developing individualized treatment plans.

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许帅.磁共振扩散加权成像对不同级别脑膜瘤的诊断价值分析[J].生物医学工程学进展,2024,45(4):293-298

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  • 收稿日期:2024-10-16
  • 最后修改日期:2024-11-05
  • 录用日期:2024-11-08
  • 在线发布日期: 2025-01-08
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