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目的评价磁共振(MRI)扩散峰度成像(DKI)在脑星形细胞瘤分级中的应用价值,及其与Ki67标记指数的相关性研究。方法收集经手术病理证实的脑星形细胞瘤病人60例,分为低级别组(WHOⅠ级、Ⅱ级)26例和高级别组(WHOⅢ级、Ⅳ级)34例。病人术前行头颅MRI平扫、增强及DKI扫描,测定肿瘤实质区平均弥散峰度(MK)值、各向异性分数(FA)值及平均扩散系数(MD)值,术后标本行Ki67免疫组化染色,采用独立样本t检验比较,组间DKI各参数值、Ki67表达水平差异;Spearman相关分析DKI各参数值与Ki67相关性。结果肿瘤实质区,高级别组MK值显著高于低级别组,差异有统计学意义(P=0.001);高级别组MD值显著低于低级别组,差异有统计学意义(P=0.002);FA值在高低级别组间比较,差异无统计学意义(P>0.05)。高级别组瘤体Ki67 29.4%±7.5%表达明显高于低级别组7.4%±2.3%,差异有统计学意义(P<0.001)。MK值(r=0.842;P=0.000)与Ki67具有正相关性;MD值(r=-0.613;P=0.000)与Ki67具有负相关性;而FA值(r=0.058;P=0.601)与Ki67无相关性。结论DKI参数MK值及MD值在高低级别组脑星形细胞瘤中存在差异,可鉴别高低级别脑星形细胞瘤,与脑星形细胞瘤Ki67表达存在相关性,间接反映肿瘤增殖活性。
Objective To evaluate the value of magnetic resonance imaging (DKI) in the classification of astrocytoma and its correlation with Ki67 labeling index. Methods Totally 60 patients with brain astrocytoma confirmed by surgery and pathology were divided into two groups: low grade group (WHOⅠand Ⅱ) and high grade group (WHO Ⅲ and Ⅳ), 34 cases. The patients underwent MRI scan and enhanced DKI scan before operation. The mean value of diffuse kurtosis, the value of anisotropy (FA) and the average diffusion coefficient (MD) of the tumor were measured. The Ki67 immunized The histochemical staining was used to compare the differences of the DKI parameters and the Ki67 expression between the two groups by using independent samples t test. Spearman correlation analysis was used to analyze the correlation between DKI parameters and Ki67. Results The MK value in the high grade group and the high grade group was significantly higher than that in the low grade group (P = 0.001). The MD value in the high grade group was significantly lower than that in the low grade group (P = 0.002) There was no significant difference in FA value between high and low grade groups (P> 0.05). The expression of Ki67 in high-grade group was 29.4% ± 7.5%, which was significantly higher than that of the low-grade group (7.4% ± 2.3%), the difference was statistically significant (P <0.001). MK value (r = 0.842; P = 0.000) was positively correlated with Ki67; MD value (r = -0.613; P = 0.000) was negatively correlated with Ki67; Ki67 no correlation. Conclusions MK and MD of DKI parameters are different in high and low grade astrocytoma, which can distinguish high and low grade astrocytoma and Ki67 expression in astrocytoma, which indirectly reflects tumor proliferation activity.