T2WI直方图鉴别诊断脑胶质母细胞瘤与单发转移瘤的价值

摘要

Objective To investigate the value of T2WI histogram analysis in differential diagnosis of glioblastoma multiform (GBM) from solitary metastasis.Methods Data of 103 patients with pathologically confirmed GBM (GBM group,n=57) and solitary brain metastasis (solitary brain metastasis group,n =46) were retrospectively reviewed.All patients underwent conventional MR scanning,including axial T1WI,T2WI,FLAIR and contrast-enhanced T1WI before surgery.The histogram metrics,including mean,standard deviation (SD),median,kurtosis and skewness were calculated from ROI,which were manually placed on the maximal section of the solid part of tumors on T2WI by using Image J software.ROCs were generated to evaluate differential diagnostic performance of the histogram metrics with significant difference between both groups.Results The values of mean,SD and median were significantly higher in GMB group than those in solitary brain metastasis group (P＜0.05).The areas under ROC curve of mean,SD and median was 0.772 (95％ CI [0.681,0.862],P＜0.001),0.719 (95％ CI [0.616,0.822],P＜0.001) and 0.767 (95％ CI [0.674,0.860],P＜0.001),respectively;and the diagnosis cutoff value of mean,SD and median was 509.575,58.844 and 550.500,respectively.The sensitivity of the three parameters was 0.719,0.702 and 0.719,and the specificity was 0.783,0.652,and 0.826,respectively.Conclusion The value of mean,SD and median of T2WI histogram analysis can be helpful to differentiating GBM and solitary brain metastasis,of which the mean value is the best for differential diagnosis.%目的 探讨T2WI直方图鉴别诊断胶质母细胞瘤(GBM)与单发转移瘤瘤体中的价值.方法 回顾性分析经手术病理确诊的GBM和单发转移瘤患者103例,其中GBM组57例,单发转移瘤组46例.所有患者术前均接受MR检查(T1WI、T2WI、T2-FLAIR和增强后T1WI).采用Image J软件于肿瘤最大层面手动勾画瘤体边界,计算直方图相关参数,包括均数、标准差、中位数、峰度值和偏度值.采用独立样本t检验比较GBM与脑单发转移瘤的直方图各参数,评价差异有统计学意义参数的诊断效能.结果 GBM组的均数、标准差及中位数均高于单发转移瘤组,差异有统计学意义(P均＜0.05).均数、标准差及中位数的ROC曲线下面积分别为0.772[95 ％CI(0.681,0.862),P＜0.001]、0.719[95％CI(0.616,0.822),P＜0.001]和0.767[95％CI(0.674,0.860),P＜0.001].以均数临界值为509.575,鉴别两种病变的敏感度为0.719,特异度为0.783;以标准差临界值为58.844,鉴别两种病变的敏感度为0.702,特异度为0.652;以中位数临界值为550.500,鉴别两种病变的敏感度为0.719,特异度为0.826.结论 肿瘤瘤体T2WI直方图均数、标准差和中位数均可用于GBM和脑单发转移瘤的鉴别,其中以均数的鉴别诊断效能最佳.