摘要
[目的]分析WHO 2～3级胶质瘤患者的伦勃朗视觉感受图像(Visually Accessible Rem-brandt Images,VASARI)特征总分水平,比较不同级别的VASARI特征分布,探索胶质瘤患者分级的潜在预测因素,帮助临床识别和管理.[方法]回顾性收集2011-2018年在复旦大学附属华山医院经病理确诊的95例WHO 2～3级(2级64例,3级31例)胶质瘤患者的分子标志物及影像资料.利用SAS 9.4软件比较不同级别胶质瘤患者间VASARI总分和各影像特征的分布差异.[结果]95例胶质瘤患者平均年龄44.0±11.24岁,其中男性50例(52.63％).WHO 3级胶质瘤患者(中位数:66.00分)的VASARI总分显著高于WHO 2级胶质瘤患者(中位数:55.00分)的VASARI总分(Z=4.23,P＜0.001).异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)状态、O6-甲基鸟嘌呤-DNA甲基转移酶(O6-methylguanine DNA methyltransferase,MGMT)状态、强化程度、增强比例、非增强比例、坏死比例、是否囊变、T1WI与FLAIR图像异常信号面积比、增强边缘厚度、增强边缘定义、非增强边缘定义、水肿比例、水肿穿过中线、深部白质入侵、增强肿瘤穿过中线、肿瘤大小等特征在WHO 2级与3级胶质瘤患者间分布差异均具有统计学意义(P均＜0.05).[结论]WHO 2级与3级胶质瘤患者的VASARI总分和影像特征分布差异明显,与增强、非增强、囊变、坏死、水肿和肿瘤大小相关的影像特征是胶质瘤患者分级的相关因素.
Abstract
[Objective]To analyze and compare the level and distribution characteristics of the Visually Accessible Rembrandt Images(VASARI)feature score in patients glioma(WHO grade 2-3)and to ex-plore potential predictors of glioma grading,aiding clinical identification and management.[Methods]Molecular markers and imaging data of 95 patients pathologically diagnosed as WHO grade 2-3 glioma(64 WHO grade 2 and 31 WHO grade 3)in Huashan Hospital of Fudan University from 2011 to 2018 were retrospectively collected.The differences in the total VASARI score and the distribution of imag-ing features between patients with different grades of glioma were compared separately using SAS 9.4 software.[Results]The mean age of the 95 subjects was 44.00±11.24 years old,of which 50(52.63％)were male.The total VASARI score was significantly higher(Z=4.23,P＜0.001)in patients with WHO grade 3 glioma(median:66.00)than those in patients with WHO grade 2 glioma(median:55.00).The distribution of isocitrate dehydrogenase(IDH)status,O6-methylguanine DNA methyltransferase(MGMT)status,enhancement quality,proportion of enhancing tumor,proportion of non-enhancing tumor,pro-portion of necrosis,cyst,T1/FLAIR ratio,the thickness of enhancing margin,the definition of en-hancing margin,the definition of non-enhancing margin,proportion of edema,edema crosses the midline,deep white matter invasion,enhancing tumor crosses the midline,and lesion size were statis-tically significant between patients with grade 2 and grade 3 glioma(P＜0.05).[Conclusion]The total VASARI scores and the distribution of imaging features were statistically significant between grade 2 and grade 3 glioma patients,with imaging features related to enhancement,non-enhancement,cyst,necrosis,edema,and lesion size being relevant factors in grading glioma patients.
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