目的:评估酰胺质子转移(APT),肿瘤血流量(TBF),表观扩散系数(ADC)联合诊断对青年患者颅内恶性肿瘤(MTs)与良性肿瘤(BTs)的鉴别诊断价值,根据2021年世界卫生组织中枢神经系统肿瘤分类的定义。
方法:15例颅内MTs患者和10例0-30岁的BTs患者接受了APTMRI检查,伪连续动脉自旋标记(pCASL),和弥散加权成像。通过使用直方图分析和Mann-WhitneyU检验来评估所有肿瘤,以比较组间每个序列的10个参数。使用受试者工作特征(ROC)曲线分析评估诊断性能。
结果:APT最大值,意思是,第十,25日,50岁,75,MTs和90百分位数明显高于BTs;MTs的TBF最小值(min)明显低于BTs;MTs的TBF峰度明显高于BTs;ADCmin,第十,MTs的第25百分位数明显低于BT(均p<0.05)。APT第50个百分位数(0.900),TBF最小值(0.813),和ADCmin(0.900)在每个序列中参数的曲线下面积(AUC)值最高。这三个参数的组合的AUC为0.933。
结论:APT的组合,TBF,通过直方图分析评估的ADC可能有助于区分年轻患者的颅内MT和BT。
OBJECTIVE: To evaluate the amide proton transfer (APT), tumor blood flow (TBF), and apparent diffusion coefficient (ADC) combined diagnostic value for differentiating intracranial malignant tumors (MTs) from benign tumors (BTs) in young patients, as defined by the 2021 World Health Organization classification of central nervous system tumors.
METHODS: Fifteen patients with intracranial MTs and 10 patients with BTs aged 0-30 years underwent MRI with APT, pseudocontinuous arterial spin labeling (pCASL), and diffusion-weighted imaging. All tumors were evaluated through the use of histogram analysis and the Mann-Whitney U test to compare 10 parameters for each sequence between the groups. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.
RESULTS: The APT maximum, mean, 10th, 25th, 50th, 75th, and 90th percentiles were significantly higher in MTs than in BTs; the TBF minimum (min) was significantly lower in MTs than in BTs; TBF kurtosis was significantly higher in MTs than in BTs; the ADC min, 10th, and 25th percentiles were significantly lower in MTs than in BTs (all p < 0.05). The APT 50th percentile (0.900), TBF min (0.813), and ADC min (0.900) had the highest area under the curve (AUC) values of the parameters in each sequence. The AUC for the combination of these three parameters was 0.933.
CONCLUSIONS: The combination of APT, TBF, and ADC evaluated through histogram analysis may be useful for differentiating intracranial MTs from BTs in young patients.