Objective:To investigate the prospect of amide proton transfer(APT) imaging based on protein concentration in brain gliomas.Methods:A total of 19 patients with brain glioma underwent needle biopsy or surgical resection were collected.They were proved to be low-grade,4 cases were grade Ⅰ,7 cases were grade Ⅱ,with high-grade tumors of 5 cases were grade Ⅲ,3 cases were grade Ⅳ.All patients underwent conventional magnetic resonance sequences (T1WI,T2WI,DWI,FLAIR,and Gd-T1WI) and APT sequence scans,APT imaging was performed prior to enhancement scan.The signal difference of the APT imaging signal was compared between the tumor parenchymal area(represented by APTmax) and the peritumoral region(the edema area or the parenchymal area within 0.5 cm,represented by APTmin).The independent sample t test was used to analyze whether the difference in APTmin and APTmax values between low-grade tumors (grade Ⅰ and Ⅱ) and high-grade tumors(grade Ⅲ and Ⅳ) was statistically significant.ANOVA was used to analyze statistically significant differences in APTmax and APTmin between gliomas.Spearman correlation analysis was used to analyze the correlation between glioma grading and APTmax and APTmin.And through the receiver operating characteristic curve (ROC curve) to analyze the differential diagnosis ability of APTmax.The difference of P＜0.05 was statistically significant.Results:The APTmax and APTmin values of lowgrade tumors were lower than those of high-grade tumors.There were significant differences in the APTmax and APTmin values from grade Ⅰ to grade Ⅳ.The APTmax of all tumors was higher than APTmin.Glioma grade was positively correlated with tumor APTmax and APTmin.Conclusion:As a non-invasive MR imaging modality,APT imaging plays an important role in the diagnosis,classification and differential diagnosis of brain tumors.%目的:探讨基于蛋白质浓度敏感的酰胺质子转移(Amide proton transfer,APT)成像在脑胶质瘤中的应用价值.方法:收集经穿刺活检或手术切除的脑胶质瘤患者共19例,经病理证实低级别Ⅰ级4例、Ⅱ级7例,高级别Ⅲ级5例、Ⅳ级3例.术前,患者均行常规磁共振序列(T1WI、T2WI、DWI、FLAIR和Gd-T1WI)及APT序列扫描,其中APT成像在增强扫描之前进行.比较APT成像信号在肿瘤实质区(用APTmax表示)、瘤旁区(水肿区或实质区0.5 cm以内为瘤旁区,用APTmin表示)的信号差异.应用独立样本t检验分析低级别肿瘤(Ⅰ、Ⅱ级)及高级别肿瘤(Ⅲ、Ⅳ级)肿瘤APTmin与APTmax值的差异是否有统计学意义.采用方差分析检验各级胶质瘤APTmax与APTmin统计学差异.采用Spearman相关分析统计胶质瘤分级与APTmax、APTmin的相关性.并通过受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线)分析APTmax的诊断效能.取P＜0.05为差异有统计学意义.结果:低级别肿瘤APTmax与APTmin值均低于高级别肿瘤.Ⅰ～Ⅳ级肿瘤APTmax与APTmin值均有统计学差异.各级肿瘤APTmax较APTmin值均高.胶质瘤级别与肿瘤APTmax与APTmin呈正相关.结论:作为非侵入性的MR成像技术,APT成像对于脑肿瘤的诊断、分级及鉴别具有重要价值.
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