Application research of quantitative dynamic contrast enhanced MRI in preoperative grading of brain glioma / 实用放射学杂志

ABSTRACT

Objective To study appliction value of quantitative dynamic contrast enhanced MRI(T1-DCE MRI)in preoperative grading of brain glioma.Methods 80 patients who were pathologically confirmed with a tumor grade (WHO grade Ⅰ 20 cases, grade Ⅱ 20 cases,grade Ⅲ 20 cases and grade Ⅳ 20 cases).All patients were examined with MR enhancements and T1-DCE MRI. The original perfusions imaging datas were analyzed using the GE Omni Kinetic software,which produced the transfer constant (Ktrans )map,the rate constant (Kep )map and fractional volume (Ve )map.Choose ROI and get values of Ktrans ,Kep and Ve .Pearson correlation was carried out to analyze the correlation between values of Ktrans ,Kep ,Ve of different grades of gliomas and pathology classifications.The Ktrans ,Kep and Ve values of the different grade gliomas were statistically analyzed using an ANOVA .Receiver operator characteristics (ROC)curve was used to analyze sensitivity and specificity of permeability parameters.Results The Ktrans ,Kep and Ve values of each levels has a strong correlation with pathological grading (r=0.95 1,0.804,0.766).There was obviously statistically significant difference between different grade groups(P < 0.01 )by Ktrans .Kep values have statistically difference between different grades except grade Ⅱ and Ⅲ.Ve values were different between different grades except grade I andⅡand grade Ⅲ and IV.Accord-ing to ROC curve,Ktrans seemed to be a better parameter for evaluating the tumor grade with the highest sensitivity and specificity. With the cutoff thresholds of Ktrans of 0.1 60,0.420 and 0.935,different grades of glioma can be differentiated with sensitivities of 90%,95%,95% and specificities of 95%,95%,85% respectively.Conclusion Quantitative analysis of microcirculation perfusion status of different grade gliomas by Ktrans values obtained from T1-DCE MRI can assessment the degree of the destruction of the blood brain barrier and evaluate the grade of gliomas more accurately before operation.