神经胶质瘤的相关组织病理学和常规/先进MRI技术。

Selim Seker, Tamer Altay, Ece Uysal, Hidayet S Cine, Ahmed Y Yavuz, Idris Avci
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摘要

目的:探讨磁共振成像(MRI)技术在脑胶质瘤组织病理学诊断中的应用价值。方法:共纳入82例胶质瘤患者。分析术前常规MRI图像(非对比T1/T2/flair/对比增强T1)和高级MRI图像(DAG和ADC作图、MRI波谱和灌注MRI [PMRI])。结果:单纯常规MRI在低级别胶质瘤和高级别胶质瘤的影像学预评估中分别占54.8%和86.3%。另外先进的MRI技术在98%的低级别胶质瘤和83.9%的高级别胶质瘤的比较中是有益的。ROC分析,ADC截止值为0.905 mm2/s (p = 0.001), rCBV截止值为1.77 (p = 0.001), Cho/NAA截止值为2.20 (p = 0.001), Cho/Cr截止值为2.01 (p = 0.001)。此外,将ADC、Cho/NAA和Cho/Cr分为4个组织病理学分级组,结果具有统计学意义(p = 0.001)。NAA/Cr值对病理分级无显著性影响。结论:在常规MRI的基础上,采用PMRI、磁共振波谱、DWI等先进MRI技术可提高脑胶质瘤组织病理学分级的准确性。
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The correlation histopathological and conventional/advanced MRI techniques in glial tumors.

Objective: We aimed to elucidate the histopathological pre-diagnosis of cranial gliomas with magnetic resonance imaging (MRI) techniques in gliomas.

Method: A total of 82 glioma patients were enrolled to our study. Pre-operative conventional MRI images (non-contrast T1/T2/flair/contrast-enhanced T1) and advanced MRI images (DAG and ADC mapping, MRI spectroscopy and perfusion MRI [PMRI]) were analyzed.

Results: Conventional MRI alone is useful in radiological pre-evaluation in low-grade glioma in 54.8% and 86.3% in high-grade glioma. Additional advanced MRI techniques were beneficial in comparing low-grade gliomas in 98% and 83.9% in high-grade glioma. On ROC analysis, ADC cutoff value 0.905 mm2/s (p = 0.001), rCBV cutoff value 1.77 (p = 0.001), Cho/NAA cut-off value 2.20 (p = 0.001), and Cho/Cr cutoff value 2.01 (p = 0.001) were achieved. Significant results were obtained when ADC, Cho/NAA, and Cho/Cr were analyzed into four histopathologically grade groups besides (p = 0.001). NAA/Cr values were not significant in pathological grading. rCBV measurements were statistically significant between Grades I and IV and between II and IV.

Conclusion: Using additional advanced MRI techniques such as PMRI, magnetic resonance spectroscopy, and DWI with conventional MRI could enhance the accuracy of histopathological grading in cranial glioma.

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[Initial experience of minimally invasive liver resection at a reference center in Mexico]. Complications in transgender patients undergoing vaginoplasty procedure. Retrospective evaluation of the effects of different anesthesia methods on emergence agitation in patients undergoing vitreoretinal surgery. Sleeve gastrectomy improves HDL function examined by Apo-A1 and atherogenic indices in non-diabetic obese patients. The correlation histopathological and conventional/advanced MRI techniques in glial tumors.
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