Page 88 - 磁共振成像2024年7期电子刊

磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7 临床研究｜｜Clinical Articles

合成MRI联合MUSE-DWI鉴别胶质瘤复发

和治疗相关改变的应用研究

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吕瑞瑞 ，杨治花 ，党佩 ，黄雪莹 ，马文富 ，金一萱 ，吕鸿洁 ，王晓东 1*
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作者单位 1.宁夏医科大学总医院放射科，银川 750003；2.宁夏医科大学总医院肿瘤医院放疗科，银川 750003；3.宁夏医科大学第
一临床医学院，银川 750003
通信作者 王晓东，E-mail: xdw80@yeah.net
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中图分类号 R445.2；R730.264 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.014
本文引用格式 吕瑞瑞, 杨治花, 党佩, 等 . 合成 MRI 联合 MUSE-DWI 鉴别胶质瘤复发和治疗相关改变的应用研究[J]. 磁共振成
像, 2024, 15(7): 81-86.
[摘要] 目的 探讨合成 MRI 定量参数联合多重灵敏度编码扩散加权成像（multiplexed sensitivity encoding diffusion weighted
imaging, MUSE-DWI）鉴别胶质瘤复发（progressive disease, PD）和治疗相关改变（treatment-related change, TRC）的应用价值。
材料与方法 本研究于 2020 年 9 月至 2022 年 11 月期间，依据纳、排标准收集胶质瘤全切术后行完整的放、化疗治疗，定期
MRI随访出现新发强化灶的患者 45例，其中 PD 组 26例、TRC组 19例。所有患者均行 MUSE-DWI、合成 MRI及对比增强 T1加
权成像（contrast enhanced T1-weighted imaging, CE_T1WI）序列。测量强化区域表观扩散系数（apparent diffusion coefficient,
ADC）及增强前、后 T1值（T1 、T1 ）、T2值（T2 、T2 ）。采用独立样本 t检验或 Mann-Whitney U检验比较合成 MRI定量
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参数和 ADC 值的组间差异，采用二元 logistic 回归及受试者工作特征（receiver operating characteristic, ROC）曲线评估单参数及
其联合的诊断效能。结果 （1）PD T1 高于 TRC（P<0.05），T1 和 ADC值低于 TRC（P<0.05），两组间 T2 、T2 差异无统
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计学意义（P>0.05）。（2）单参数分析时，ADC 值诊断效能最高（AUC=0.878），其次是 T1 、T1 （AUC 为 0.783、0.745）。
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T1 、T1 两者联合时，诊断效能较单参数提高（AUC=0.850）。多参数联合模型（T1 +T1 +ADC）诊断效能最高（AUC=
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0.901）。结论 合成MRI定量参数（T1 、T1 ）联合ADC值的多参数联合模型，在鉴别胶质瘤PD和TRC中具有一定价值。
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[关键词] 胶质瘤；合成磁共振成像；磁共振成像；多重灵敏度编码；复发；治疗相关改变
Application of synthetic MRI combined with MUSE-DWI to differentiate glioma progressive
disease from treatment-related changes
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LÜ Ruirui , YANG Zhihua , DANG Pei , HUANG Xueying , MA Wenfu , JIN Yixuan , LÜ Hongjie , WANG Xiaodong 1*
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1 Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750003, China; Department of Radiotherapy,
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Cancer Hospital of Ningxia Medical University General Hospital, Yinchuan 750003, China; The First Clinical Medical College of
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Ningxia Medical University, Yinchuan 750003, China
* Correspondence to WANG X D, E-mail: xdw80@yeah.net
Received 4 Feb 2024, Accepted 12 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.014
ACKNOWLEDGMENTS Natural Science Foundation of Ningxia Hui Autonomous Region (No. 2023AAC03557); 2023 New Master
Talent Training Program of General Hospital of Ningxia Medical University [No. (2023) 394].
Cite this article as LÜ R R, YANG Z H, DANG P, et al. Application of synthetic MRI combined with MUSE-DWI to differentiate
glioma progressive disease from treatment-related changes[J]. Chin J Magn Reson Imaging, 2024, 15(7): 81-86.
Abstract Objective: To assess the utility of synthetic MRI quantitative parameters and multiplexed sensitivity encoding diffusion
weighted imaging (MUSE-DWI) in combination to differentiate glioma progressive disease (PD) from treatment-related change (TRC).
Materials and Methods: In this study, we collected 45 patients who exhibited new enhancing lesions after surgery followed by
completion of chemoradiation therapy from September 2020 to November 2022. The scan sequences included synthetic MRI,
MUSE-DWI and contrast enhanced T1-weighted imaging (CE_T1WI). The patients were classified into two groups: PD group (n=26)
and TRC group (n=19). The ROI is placed on each image to measure apparent diffusion coefficient (ADC), pre-contrast T1, T2 value
(T1 , T2 ) and post-contrast T1, T2 value (T1 , T2 ). Quantitative parameters (T1 , T2 and T1 , T2 ) and ADC were evaluated
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using Student's t-test or Mann-Whitney U test. We generated receiver operating characteristic (ROC) curves for each parameter and their
combinations. Finally, we used the area under the ROC curve (AUC) to assess the performance of each parameter and their combinations.
Results: (1) The T1 value in the PD group were significantly higher than the TRC group (P<0.05). The values of T1 and ADC in the
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PD group were significantly lower than the TRC group (all P<0.05). There was no statistical difference in T2 , T2 value (P>0.05). (2)
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ADC diagnostic performance was highest when using single parameter analysis (AUC=0.878), followed by T1 and T1 with AUC of
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0.783 and 0.745, respectively. The combinations of two parameters (T1 +T1 ) improved the diagnostic performance (AUC=0.850)
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compared to the single parameter. A combined multi-parameter model (T1 +T1 +ADC) was established with the highest diagnostic
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efficacy (AUC=0.901). Conclusions: The combinations of the two techniques to construct a multiparametric combined model of
relaxation quantitative parameters (T1 , T1 ) combined with ADC values have a good diagnostic value in differentiating PD and
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TRC.
Key words glioma; synthetic magnetic resonance imaging; magnetic resonance imaging; multiplexed sensitivity-encoding; progressive
disease; treatment-related change
收稿日期 2024-02-04 接受日期 2024-07-12
基金项目 宁夏回族自治区自然科学基金项目（No. 2023AAC03557）；宁医大总院 2023年新入职硕士人才培养项目（编号：〔2023〕
394号）
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