作　　者： (董飞）; (张佩佩）; (蒋飚）; (李倩）; (曾强）; (王维维）; (庞佩佩）; (张敏鸣）;

机构地区： 浙江大学医学院附属第二医院放射科,杭州310009

出　　处： 《中华放射学杂志》 2017年第8期568-571,共4页

摘　　要： 目的 利用动态对比增强MRI（DCE-MRI）的容积转移常数（Ktrans）定量评估胶质瘤Ki-67标记指数（Ki-67 labeling index,Ki-67 LI）的价值.方法 2014年1月至2016年1月搜集20例经常规病理确诊的胶质瘤患者,术前行颅脑DCE-MRI检查,利用动态对比增强专用血流动力学软件分析胶质瘤强化部分的Ktrans值,术后病理切片通过免疫组织化学方法检测Ki-67 LI,并分为高（＞10%）、低（≤10%）两组,利用Spearman相关检验分析Ktrans值与胶质瘤Ki-67 LI之间的相关性,利用秩和检验（Mann-Whitney U检验）比较高、低Ki-67 LI两组间Ktrans值的差异.结果 胶质瘤Ktrans值[0.1252（0.0165~0.8048）]与Ki-67 LI[20%（5%~50%）]呈正相关（r=0.721,P＜0.001）;低Ki-67 LI组胶质瘤的Ktrans值[0.0697（0.0165~0.1456）]与高Ki-67 LI组的Ktrans值[0.1810（0.0810~0.8048）]差异有统计学意义（Z=-3.209,P=0.001）;绘制ROC曲线,曲线下面积（AUC）为0.945,鉴别胶质瘤高、低Ki-67 LI的敏感度为92.3%,特异度为85.7%.结论 Ktrans值可用于定量评估胶质瘤Ki-67 LI. Objective To study the value of transfer constant（Ktrans）derived from dynamic contrast-enhanced MRI （DCE-MRI） for quantitative evaluation of Ki-67 labeling index （Ki-67 LI） in glioma. Methods Twenty patients with glioma who underwent DCE-MRI and operation were retrospectively reviewed. The Ktrans value and Ki-67 LI were acquired and correlated using the Spearman correlation test. Also, the Ktrans values were compared between high（larger than 10%）and low（no more than 10%）Ki-67 LI group with Mann-Whitney U test, receiver operating characteristic curves was performed to evaluate the diagnostic value. Results The Ktrans value（0.0165 to 0.8048, median 0.1252）was significantly associated with Ki-67 LI（5%to 50%, median 20%） （r=0.721,P〈0.001）, and the Ktrans value was significantly higher in high Ki-67 group（0.0810 to 0.8048, median 0.1810）than that in low Ki-67 LI group（0.0165 to 0.1456, median 0.0697）（Z=-3.209, P=0.001）. The most predictive Ktrans value differentiated high Ki-67 LI and low Ki-67 LI with an area under the curve（AUC） of 0.945 at a sensitivity of 92.3% and specificity of 85.7%. Conclusion Ktrans value could be used for quantitative evaluation of Ki-67 LI in glioma.

关 键 词： 胶质瘤 磁共振成像 抗原