摘要
目的 探讨无创反映脑胶质瘤细胞增殖及IDH基因表型的MRI特征.方法 选取我院经病理证实的 120例脑胶质瘤患者临床及MRI资料,MRI检查包括常规平扫及增强扫描、DWI、DTI、MRS及 3D ASL检查.应用免疫组化检测胶质瘤组织Ki-67 表达情况,PCR测序法检测胶质瘤组织IDH1、P53 的突变情况.所有数据处理应用SPSS26.0 统计软件分析,P<0.05 为差异有统计学意义.结果 Ki-67 标记指数与强化、瘤周水肿、性质、年龄、病理学分级、肿瘤区rCBF值及水肿区rCBF值呈正相关(P<0.05),IDH1mut与IDH1wild胶质瘤组间强化程度、T2-FLAIR失配征、肿瘤区rCBF值、水肿区rCBF值、瘤体区rADCmin值及肿瘤区Cho/NAA比值差异均有统计学意义(P<0.05),胶质瘤P53 突变状态与性别、性质、肿瘤区rCBF值及rFAmean差异均有统计学意义(P<0.05).结论 术前肿瘤区rCBF值有助于胶质瘤IDH1 基因分型,预测Ki-67 基因表达程度.T2-FLAIR失配征、rCBF值可成为评价IDH1 基因表型MRI特征.
Abstract
Objective To find MRI features that noninvasively reflect the cell proliferation,and IDH genotype of glioma.Methods We retrospectively analyzed 120 patients with glioma confirmed by postoperative pathology in our hospital.MRI ex-aminations included head routine scans,enhanced scans,DWI,DTI,MRS,and 3D ASL.Immunohistochemistry was applied to detect Ki-67 expression in glioma,and PCR sequencing was applied to detect IDH1 and P53 mutations in glioma.All data were analyzed by SPSS26.0 statistical software,and the difference was considered statistically significant at P<0.05.Results Ki-67 labeling index was positively correlated with enhancement,peritumoral edema,nature,age,pathological grade and rCBF value in tumor area and edema area(P<0.05).The degree of enhancement,T2-FLAIR mismatch sign,tumor area and edema area rCBF value,rADCmin value in the tumor area and Cho/NAA ratio in the tumor area were statistically different between IDH1mut and IDH1wild glioma groups(P<0.05).The P53 mutation status of glioma was statistically significant with respect to gen-der,nature,rCBF value in the tumor area and rFAmean(P<0.05).Conclusion Preoperative tumor area rCBF value can help glioma IDH1 genotyping and predict the degree of Ki-67 gene expression.T2-FLAIR mismatch sign and rCBF value can be MRI features to evaluate IDH1 genotype.
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