Apparent diffusion coefficient predicts the pathological grade of meningioma and its correlation with the Ki-67 proliferation index
方磊 1方慧 2耿源源 3殷润 2刘新疆2
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 滨州医学院医学影像学院,山东烟台 264003
2. 复旦大学附属浦东医院放射科,上海 201399
3. 复旦大学附属浦东医院病理科,上海 201399
折叠
摘要
目的:探讨表观弥散系数(apparent diffusion coefficient,ADC)鉴别诊断脑膜瘤组织病理学分级的价值及其与Ki-67增殖指数的关系.方法:回顾并分析经术后病理学检查证实为脑膜瘤的51例患者资料,根据世界卫生组织(World Health Organization,WHO)病理学分级分为低级别脑膜瘤(low-grade meningioma,LGM)组45例和高级别脑膜瘤(high-grade meningioma,HGM)组6例,计算平均ADC(ADCmean)、最小ADC(ADCmin),以及两者相对值(rADCmean、rADCmin).比较两组ADCmean、ADCmin、rADCmean、rADCmin的差异.绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估ADC各参数的鉴别诊断效能,并采用DeLong检验比较ROC曲线的曲线下面积(area under the curve,AUC)的差异.采用Spearman相关分析评估ADC各参数与Ki-67增殖指数之间的相关性.结果:LGM组的ADCmean、ADCmin、rADCmean及rADCmin均高于HGM组,组间差异有统计学意义(P＜0.05).4种ADC参数均有较好的诊断效能,DeLong检验显示AUC两两比较差异均无统计学意义(P＞0.05),其中ADCmin的鉴别诊断效能最高,其最佳截断值为0.657 × 10-3 mm2/s,灵敏度为66.67％,特异度为95.56％.ADCmean、ADCmin、rADCmean及rADCmin均与Ki-67增殖指数呈负相关(P＜0.05).结论:ADC有助于术前预测脑膜瘤的病理学分级及Ki-67增殖指数,可为临床诊疗提供支持.
Abstract
Objective:To investigate the value of apparent diffusion coefficient(ADC)for differential diagnosis of histopathologic grade of meningiomas and its relationship with Ki-67 proliferation index.Methods:The data of 51 patients with meningioma confirmed by surgery and pathology were reviewed and analyzed.According to the World Health Organization(WHO)pathological grade,patients were divided into low-grade meningioma(LGM)group(45 cases)and high-grade meningioma(HGM)group(6 cases).The average ADC(ADCmean),minimum ADC(ADCmin),and their relative values(rADCmean and rADCmin)were calculated.The differences of ADCmean,ADCmin,rADCmean and rADCmin between the two groups were compared.The receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy of each ADC parameter's diagnostic efficacy,and DeLong's test was used to compare the difference in area under curve(AUC)of the ROC curve.Spearman correlation analysis was performed to assess the correlation between each of the ADC parameters and Ki-67 proliferation index.Results:The ADCmean,ADCmin,rADCmean and rADCmin values of the LGM group were higher than those of the HGM group,and the differences between the groups were all statistically significant(P＜0.05).The four ADC parameters all had good diagnostic efficacy,DeLong test showed that there was no significant difference in AUC between any two groups(P＞0.05).And ADCmin had the best differential diagnostic efficacy.The optimal cut-off value of ADCmin was 0.657 x 10-3 mm2/s,and the sensitivity was 66.67％,and the specificity was 95.56％.ADCmean,ADCmin,rADCmean and rADCmin values were all negatively correlated with Ki-67 proliferation index(P＜0.05).Conclusion:ADC values were helpful to predict the pathological grade of meningiomas and Ki-67 proliferation index before operation,and it can provide support for clinical diagnosis and treatment.
关键词
脑膜瘤/磁共振成像/表观弥散系数/Ki-67增殖指数
Key words
Meningioma/Magnetic resonance imaging/Apparent diffusion coefficient/Ki-67 proliferation index
维普
万方数据