目的 探讨非对比增强MP2RAGE技术对弥漫性胶质瘤的分级、IDH-1基因状态及肿瘤细胞增值活性中的评估作用。材料与方法 回顾性分析经病理证实弥漫性胶质瘤患者共99例，其中Ⅱ级38例，Ⅲ级28例，Ⅳ级33例。并测得IDH-1 突变状态共86例，（IDH-1 突变型30例，IDH-1 野生型56例）。所有患者均行常规MRI及MP2RAGE检查，MP2RAGE 技术在线生成T1 mapping伪彩图。在配准图像上手动勾画感兴趣区（ROI），测得并记录肿瘤实质区及对侧正常白质区T1值,二者比值定义为标准化rT1值。比较不同级别弥漫性胶质瘤的rT1值差异；比较弥漫性胶质瘤IDH-1突变型和IDH-1野生型间rT1值的差异，并绘制ROC曲线分析rT1 值对IDH-1基因状态的评估效能；我们还分析了标准化rT1值与Ki-67标记指数的相关性。结果 标准化rT1值在Ⅱ级和Ⅳ级胶质瘤之间和Ⅲ级和Ⅳ级胶质瘤之间有显著统计学差异 （P<0.01）；而在Ⅱ级和Ⅲ级胶质瘤之间没有统计学意义（P>0.05）。IDH-1突变型的rT1值较IDH-1野生型的rT1值低，并有统计学意义（P<0.05），ROC分析显示rT1值曲线下面积为0.675，敏感性为50%，特异性为86.7%。rT1值与Ki-67具有明显正相关性(r=0.51,P<0.01)。结论 非对比增强MP2RAGE技术对弥漫性胶质瘤的分级及IDH-1基因状态的评估具有一定得价值。

Objective To investigate the value of non- enhanced MP2RAGE technique in the evaluation of grading, IDH-1 mutation status and tumor cell proliferation activity of diffuse glioma. Materials and Methods A total of 99 patients with pathologically confirmed diffuse glioma were retrospectively analyzed, including 38 grade II, 28 grade III, and 33 grade IV cases. A total of 86 cases with IDH-1 mutation status were detected (30 cases of IDH-1 mutant type and 56 cases of IDH-1 wild type). All patients underwent conventional MRI and MP2RAGE examination, and the T1 values of tumor parenchyma and contralateral normal white matter were measured and recorded by manual delineation of ROI on T1 mapping pseudo-color map generated online by MP2RAGE technology. The ratio of tumor parenchyma and contralateral normal white matter was defined as the standardized rT1 value. The difference of rT1 values in different grades of gliomas was compared and the correlation between rT1 value and the Ki-67 index was conducted. Then we compared the differences of rT1 values between IDH-1 mutant and IDH-1 wild type in diffuse gliomas, Receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of T1 value in assessing IDH-1 mutation status. Results Standardized rT1 values were statistically different between grades II and IV gliomasand also between grades III and IV gliomas (P<0.01), while there were no statistical significance between grades II and III gliomas (P>0.05). The rT1 value of IDH-1 mutant was significantly lower than that of IDH-1 wild-type (P<0.05), The area under the ROC curve of rT1 value was 0.675, and the sensitivity specificity were 50% and 86.7%, respectively. The rT1 value was positively correlated with Ki-67 (r=0.51, P<0.01). Conclusion Non-enhanced MP2RAGE technique has certain value in the grading of diffuse glioma and the assessment of IDH-1 mutation status.

类型:内蒙古自治区科技计划项目(编号2019GG047)