摘要
目的:分析多模态MRI联合影像组学在胶质瘤诊治中的应用价值。方法:选取2016年1月—2023年6月我院收治的老年高级别胶质瘤患者200例为病例组,另选取同期诊治的颅内良性非胶质瘤患者60例为对照组。两组均行多模态MRI检查获取表观扩散系数(ADC)值、脑血流量(CBF)、胆碱复合物(Cho)/肌酸(Cr)、N-乙酰天门冬氨酸复合物(NAA)/Cr、Cho/NAA,并获取影像组学特征,高级别胶质瘤患者采用手术切除及放化疗进行治疗,采用ROC曲线分析多模态MRI、影像组学单一及联合对胶质瘤的诊断价值及疗效预测的价值。结果:与对照组相比,病例组ADC值、NAA/Cr水平降低,CBF、Cho/Cr、Cho/NAA水平上升(P<0.05)。与治疗前相比,治疗后ADC值、NAA/Cr水平上升,CBF、Cho/Cr、Cho/NAA水平降低(P<0.05)。与治疗有效患者相比,治疗无效患者ADC值、NAA/Cr水平降低,CBF、Cho/Cr、Cho/NAA水平上升(P<0.05)。ROC曲线显示,与影像组学单项诊断相比,联合检测诊断胶质瘤的敏感性、准确性升高(P<0.05)。ROC曲线显示,与影像组学单项诊断相比,联合检测预测胶质瘤疗效的敏感性、准确性升高(P<0.05)。结论:老年胶质瘤患者多模态MRI检查的ADC值、NAA/Cr水平降低,Cho/Cr、Cho/NAA、CBF水平上升,多模态MRI联合影像组学在老年胶质瘤临床诊断、疗效预测中具有较理想的应用价值。
Objective:To analyze the application effect of multimodal magnetic resonance imaging(MRI)combined with radiomics in the diagnosis and treatment of glioma.Methods:From January 2016 to June 2023,200 elderly patients with highgrade glioma admitted to our hospital were selected as the case group,and 60 patients with non-glioma intracranial benign tumor treated during the same period were selected as the control group.Multimodal MRI examinations were performed in both groups to obtain parameters including apparent diffusion coefficient(ADC)values,cerebral blood flow(CBF),choline complex(Cho)/creatine(Cr),N-acetyl aspartate complex(NAA)/Cr,Cho/NAA,and radiomic features were obtained in simultaneously High-grade glioma patients were treated with surgical resection and radiotherapy and chemotherapy.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value and prognosis value of multimodal MRI,radiomics alone and their combination in glioma.Results:Compared with control group,ADC value and NAA/Cr level were decreased in case group,while CBF,Cho/Cr and Cho/NAA levels were increased(P<0.05).Compared with before treatment,ADC value and NAA/Cr level were increased after treatment,while CBF,Cho/Cr and Cho/NAA levels were decreased(P<0.05).Compared with the patients with effective treatment,ADC value and NAA/Cr level were decreased in patients with ineffective treatment,while CBF,Cho/Cr and Cho/NAA levels were increased(P<0.05).ROC curve showed that compared with radiomics alone,the sensitivity and accuracy of combined detection in the diagnosis of glioma were increased(P<O.05).ROC curve showed that compared with single diagnosis of radiomics,the sensitivity and accuracy of combined detection in predicting the efficacy of glioma were significantly higher(P<O.O5).Conclusion:ADC values and NAA/Cr levels of multimodal MRI parameters in elderly glioma patients decreased,while Cho/Cr,Cho/NAA and CBF levels increased.Multimodal MRI combined with radiomics has ideal application value in the clinical diagnosis and therapeutic effect prediction of elderly glioma patients.
作者
吴迪扬
杜金
张洁
纪珊珊
韩德昌
付维来
WU Di-yang;DU Jin;ZHANG Jie;JI Shan-shan;HAN De-chang;FU Wei-lai(Tangshan Gongren Hospital,Tangshan Hebei 063000,China)
出处
《中国临床医学影像杂志》
北大核心
2026年第3期153-157,共5页
Journal of China Clinic Medical Imaging
基金
河北省2024年度医学科学研究课题计划(编号:20241188)。
