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目的 用受试者操作特性 (receiveroperatingcharacteristic ,ROC)分析方法评价MR、CT对颅内恶性胶质瘤术后早期残存肿瘤的检查价值。方法 回顾性分析经手术与病理证实的幕上脑皮层及皮层下恶性胶质瘤 2 0 0例 (男 138例 ,女 6 2例 ,年龄 17～ 6 8岁 ,平均 36 9岁 )。 2 0 0例中术后肿瘤残存 5 4例 (2 7% ) ,均经 2次手术证实 ;其余 146例术后影像学随诊至少 2年以上无复发表现。采用Windows 95版ROCKIT软件进行ROC分析 ,使用微软Excel 8 0软件绘制ROC曲线图。结果 2 0 0例颅内幕上恶性胶质瘤术后MR与CT检查ROC分析显示 ,CT曲线的截距 (a值 )为 0 7372 ,斜率 (b值 )为 1 15 5 5 ,曲线下面积 (Az)为 0 6 85 2 ;MR曲线的a值为 2 15 6 0 ,b值为 0 9940 ,Az为 0 936 9。两种方法的ROC曲线及Az明显不同 ,两者的差别有显著性意义 (P <0 0 1)。结论 MR在恶性胶质瘤术后早期对肿瘤残存的检出上明显优于CT。
Objective To evaluate the value of MR and CT in the early postoperative residual tumors of intracranial malignant gliomas using the receiver operating characteristic (ROC) analysis method. Methods A retrospective analysis of 200 cases of supratentorial cortical and subcortical malignant gliomas confirmed by surgery and pathology (138 males and 62 females, aged 17 to 68 years, mean 36 9 years old). Twenty-five cases of post-operative tumor remnants (54 cases, 27%) were confirmed by 2 operations. The remaining 146 cases were followed up for at least 2 years without recurrence. The ROC analysis was performed using the Windows 95 version of ROCKIT software. The ROC curve was plotted using Microsoft Excel 80 software. Results ROC analysis of 200 cases of intracranial glioblastoma MRI after MR and CT showed that the intercept (a value) of the CT curve was 0 7372, the slope (b value) was 1 15 5 5, and the area under the curve ( Az) is 0 6 85 2 ; the a value of the MR curve is 2 15 6 0, the b value is 0 9940, and the Az is 0 936 9. The ROC curve and Az of the two methods are significantly different, and the difference between the two methods is significant (P < 0 01). Conclusion MR is superior to CT in the early detection of malignant gliomas.