| 胡丽娟,廖凯兵.应用ROC曲线评价3.0T 1H-MRS对脑胶质瘤分级的诊断效能[J].肿瘤学杂志,2017,23(3):194-198. |
| 应用ROC曲线评价3.0T 1H-MRS对脑胶质瘤分级的诊断效能 |
| Evaluation of Diagnostic Efficiency of 3.0T 1H-MRS in the Histopathological Grading of Brain Gliomas |
| 投稿时间：2016-07-20 |
| DOI：10.11735/j.issn.1671-170X.2017.03.B007 |
|
 |
| 中文关键词: 胶质瘤 磁共振波谱学 ROC曲线 |
| 英文关键词:glioma magnetic resonance receiver operating characteristic curve |
| 基金项目: |
|
| 摘要点击次数: 1770 |
| 全文下载次数: 483 |
| 中文摘要: |
| 摘 要：［目的］ 分析脑胶质瘤氢质子磁共振波谱（1H-MRS）表现，通过受试者工作特征曲线（receiver operating characteristic curve，ROC）来确定1H-MRS各项代谢产物对胶质瘤分级的诊断效能。［方法］ 经病理证实的脑胶质瘤患者55例，按世界卫生组织（WHO）2007年胶质瘤分类分级标准，其中低级胶质瘤（Ⅰ、Ⅱ级）27例，高级胶质瘤（Ⅲ、Ⅳ级）28例；所有患者在术前行3.0T 1H-MRS检查，检测肿瘤实质部分胆碱复合物（choline，Cho）/肌酸（creatine，Cr）、N-乙酰天门冬氨酸复合物（N-acetyl aspartic acid，NAA）/Cho、NAA/Cr值，并用ROC曲线分析各指标对胶质瘤分级诊断的敏感度、特异性及最佳诊断阈值。［结果］ 57例胶质瘤Cho/Cr值均较对侧正常脑组织升高，NAA/Cho及NAA/Cr值较对侧降低。低、高级胶质瘤肿瘤实质部分Cho/Cr、NAA/Cho比值差异有统计学意义（P<0.05），而NAA/Cr比值无统计学差异（P>0.05）。脑胶质瘤肿瘤实质部分的Cho/Cr比值与肿瘤级别呈显著正相关（r=0.600，P<0.001），而NAA/Cho比值与肿瘤级别呈显著负相关（r=-0.573，P<0.001），NAA/Cr值与肿瘤级别无明显相关(P>0.05)。Cho/Cr、NAA/Cho、NAA/Cr的ROC曲线下面积（area under curve ，AUC）分别为0.847、0.831、0.530。取Cho/Cr=2.796为阈值鉴别不同级别脑胶质瘤，其敏感度为75.0%，特异性为85.2%；取NAA/Cho=0.349为阈值鉴别不同级别脑胶质瘤，其敏感度为85.2%，特异性为78.6%；NAA/Cr值对鉴别不同级别胶质瘤诊断意义不大。［结论］ 1H-MRS能反映胶质瘤细胞的生化物质代谢情况，结合ROC曲线分析，Cho/Cr及NAA/Cho比值对胶质瘤分级诊断具有较大价值，可为脑胶质瘤术前分级诊断提供定量指标。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the diagnostic efficiency of 3.0T multivoxel proton magnetic spectroscopy(1H-MRS) in pathological grading of brain gliomas. ［Methods］ Fifty-five patients of pathologically proved brain gliomas，including 27 cases of low-grade gliomas(grade Ⅰ~Ⅱ) and 28 cases of high-grade gliomas(grade Ⅲ~ Ⅳ) were enrolled in the study. Patients underwent 3.0T 1H-MRS examination before operation. The variety of metabolite peaks were detected，including the ratios of choline/creatine(Cho/Cr)，N-acetyl aspartic acid/Cho(NAA/Cho) and NAA/Cr. The sensitivity，specificity and cut-off value of each index were analyzed by receiver operating characteristic curve(ROC). ［Results］ Significant differences were found in the ratios of Cho/Cr and NAA/Cho between low grade gliomas and high grade gliomas(P<0.05)，but there was no significant difference in NAA/Cr(P>0.05). Significant correlation was found between the ratios of Cho/Cr，NAA/Cho and the pathological grading of gliomas. Significant positive correlation was found in ratio of Cho/Cr with the pathological grading of gliomas(r=0.600，P<0.001)，and negative correlation was found in ratio of NAA/Cho with the pathological grading of gliomas(r=-0.573，P<0.001). There was no significant correlation between the ratio of NAA/Cr and the pathological grading of gliomas. The area under the curve(AUC) of Cho/Cr，NAA/Cho，NAA/Cr were 0.847，0.831，0.530，respectively. The cut-off value of Cho/Cr for differential diagnosis of high grade and low grade brain gliomas was 2.796，with a sensitivity of 75.0% and a specificity of 85.2%. The cut-off value of NAA/Cho for differential diagnosis of high grade and low grade brain gliomas was 0.349，with a sensitivity of 85.2% and a specificity of 78.6%. ［Conclusion］ 1H-MRS can reflect the metabolic information of brain gliomas. ROC curve analysis shows that the ratio of Cho/Cr and NAA/Cho may be of value in histopathological grading of brain gliomas. |
|
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |