目的：探讨ADC全域直方图在鉴别胶质母细胞瘤和脑单发转移瘤中的应用价值。方法：回顾性分析我院经手术病理证实的30例胶质母细胞瘤及28例脑单发转移瘤患者的资料，在两组肿瘤ADC图像中包含肿瘤的所有层面上应用Mazda软件勾画的ROI，并进行全域直方图分析，得到9个直方图参数，对两组肿瘤直方图参数特征进行统计学分析，获得两组肿瘤间差异有统计学意义的参数特征，并绘制受试者操作特征（ROC）曲线以评价其鉴别胶质母细胞瘤和脑单发转移瘤的价值。结果：直方图提取出的9个参数特征中，两组间平均值、偏度、第1百分位数、第10百分位数、第50百分位数、第90百分位数、第99百分位数的差异有统计学意义（P<0.05），其ROC曲线下面积分别为0.792、0.658、0.674、0.736、0.801、0.735、0.699，平均值鉴别两种肿瘤的敏感度、特异度分别为70.0%和78.6%；偏度鉴别两种肿瘤的敏感度、特异度分别为60.7%和60.0%；第1百分位数鉴别两种肿瘤的敏感度、特异度分别为76.7%和64.3%；第10百分位数鉴别两种肿瘤的敏感度、特异度分别为70.0%和67.9%；第50百分位数鉴别两种肿瘤的敏感度、特异度分别为63.3%和78.6%；第90百分位数鉴别两种肿瘤的敏感度、特异度分别为70.0%和75.0%；第99百分位数鉴别两种肿瘤的敏感度、特异度分别为70.0%和60.7%。结论：ADC全域直方图分析可作为鉴别胶质母细胞瘤和脑单发转移瘤的重要辅助手段。
Abstract
Objective: To explore the value of ADC whole-tumor histogram in differentiating glioblastom from solitary brain metastasis. Methods: Retrospective analysis of 30 cases of glioblastom and 28 cases of solitary brain metastasis which were pathologically confirmed was done. Region of interest(ROI) on each slice of ADC maps including tumor was drawn and the histogram was analyzed. The two steps were both conducted by the software Mazda. The histogram parameters were analyzed statistically to find out if there is significant difference between the two groups. Next, receiver operating characteristic(ROC) curve was drew to assess diagnostic efficiency. Results: As for the 9 parameters extracted from histogram, the difference of the mean, skewness, the 1th, 10th, 50th, 90th, 99th percentiles between the two groups showed statistical significance(P<0.05). Areas under the ROC curve were 0.792, 0.658, 0.674, 0.736, 0.801, 0.735, 0.699, respectively. The sensitivity and the specificity of mean value in differentiation were 70.0% and 78.6%, respectively. And those for skewness, 1th percentile, 10th percentile, 50th percentile, 90th percentile and 99th percentile were 60.7% and 60.0%, 76.7% and 64.3%, 70.0% and 67.9%, 63.3% and 78.6%, 70.0% and 75.0%, 70.0% and 60.7%, respectively. Conclusion: ADC whole-tumor histogram analysis can be used as an important supplementary method to differentiate glioblastom from solitary brain metastasis.
关键词
脑肿瘤 /
胶质母细胞瘤 /
磁共振成像
Key words
Brain neoplasms /
Glioblastoma /
Magnetic resonance imaging
中图分类号：
Ｒ739.41
Ｒ730.264
Ｒ445.2
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基金
国家重点研发计划数字诊疗装备研发重点专项：MRI设备及临床应用评价研究（2016YFC0106900）；MRI临床效果评价研究（2016YFC0106902）。
