立体定向和功能性神经外科杂志 ›› 2023, Vol. 36 ›› Issue (5): 262-268.DOI: 10.19854/j.cnki.1008-2425.2023.05.0002

• 论著 • 上一篇    下一篇

IDH1与高级别脑胶质瘤治疗后MRI特征及预后分析

刘梦, 杜云, 刘佳, 姚萌萌, 王卫中   

  1. 071000 保定 河北省保定市儿童医院放射科(刘梦,王卫中),检验科(杜云),静配中心(刘佳);保定市第七医院神经外科(姚萌萌)
  • 收稿日期:2023-08-05 出版日期:2023-10-25 发布日期:2023-12-05
  • 通讯作者: 王卫中 Syber-shot@163.com
  • 基金资助:
    保定市科技计划项目(编号:2141ZF111)

Analysis of MRI features and prognostic indicators of IDH1 high-grade glioma after treatment

Liu Meng, Du Yun, Liu Jia, et al   

  1. Department of Laboratory,Baoding Children's Hospital,Baoding,072150,China
  • Received:2023-08-05 Online:2023-10-25 Published:2023-12-05

摘要: 目的 研究评估高级别脑胶质瘤异柠檬酸脱氢酶1(isocitrate dehydrogenase-1,IDH1)与治疗后MRI特征以及预后相关性。方法 回顾性分析2014年1月到2021年1月到我院进行治疗的高级别胶质瘤(high grade glioma,HGG)患者,对患者的临床资料及术后MRI进行收集。最终纳入96名HGG患者,其中IDH基因野生型61例,突变型35例。应用Siemens Syngo.via工作站图像处理6个月随访时MRI图像,获得DTI的各向异性分数(fractional anisotropy,FA)图、动脉自旋标记(arterial spin labeling,ASL)的脑血流量(cerebral blood flow,CBF)和DWI的表观弥散系数(apparent diffusion coefficient,ADC)。结果 IDH突变型患者中Ⅲ级患者较多,IDH野生型中Ⅳ级患者较多。在DWI序列帧,突变型患者nADC更高,而nCBF更低(P<0.05)。在SWI序列中,IDH1野生型患者肿瘤内磁敏感信号(intra-tumoral susceptibility signal,ITSS)3级患者数量更多(P<0.05)。生存随访时间15~43个月,中位随访时间26个月,IDH1野生型HGG患者的中位无进展生存期(progression free survival,PFS)为10个月,IDH1突变型中位PFS为17个月,两组患者PFS之间差异存在统计学意义(P<0.05),IDH1野生型HGG患者的中位总生存期(Overall survival,OS)为13个月,而IDH1突变型中位OS为22.5个月,两组患者OS之间差异存在统计学意义(P<0.05)。IDH1基因型对HGG患者预后的ROC曲线下面积为0.585,联合nADC、nCBF、ITSS分级对HGG患者预后的ROC曲线下面积为0.874,进一步联合病理组织学分级对HGG患者预后的ROC曲线为0.926。结论 HGG患者IDH1野生型和突变型患者MRI特征参数存在差异,联合IDH1基因型、MRI特征参数和病理组织分级对HGG患者预后评估有一定价值。

关键词: 高级别脑胶质瘤, 异柠檬酸脱氢酶1, MRI, 基因突变

Abstract: Objective To study the correlation between isocitrate dehydrogenase-1 (IDH1) and post-treatment MRI features and itsprognosis value in high-grade gliomas.Methods Retrospectively analysis was performed on clinical,IDH gene type and postoperative MRI data from HGG patients who came toour hospital for treatment from January 2014 to January 2021.96 HGG patients were included with 61 were IDH wild-type and 35 mutant type.DTT map,fractional anisotropy (FA) map of DTI,cerebral blood flow (CBF) of ASL and apparent diffusion coefficient (ADC) of DWI were obtained after 6 month post-treatmentMRIimage processing on Siemens Syngo.via workstation coefficient.Results There were more patients with grade IV in IDH wild type.In the DWI sequence frame,mutant patients presented highernADCbut lowernCBF(P<0.05).In SWI sequence,the number of IDH1 wild-type patients with ITSS3 grades was higher than that of IDH1-mutant glioma patients (P>0.05).The follow-up time of patients was between 15~43 months,and the median follow-up time was 26 months.The median PFS of IDH1 wild-type HGG patients was 10 months,and the median PFS of IDH1 mutant HGG patients was 17 months (P<0.05).The median OS of IDH1 wild-type HGG patientswas 13 months,and the median OS of IDH1 mutant HGG patients was 22.5 months(P<0.05).The area under the ROC curve of IDH1 genotype for the prognosis of HGG patients was 0.585,the area under the ROC curve of the combination of nADC,nCBF,and ITSS grades for the prognosis of HGG patients was 0.874.While the ROC curve combined with IDH1 genotype,nADC,nCBF,ITSS grade and histopathological grade for the prognosis of HGG patients was 0.926.Conclusion There are differences in MRI characteristic parameters between IDH1 wild type and mutant HGG patients,and the combination of IDH1 genotype,MRI characteristic parameters and histopathological grade has positive significance for evaluating prognosis of HGG patients.

Key words: High-grade glioma, Isocitrate dehydrogenase 1, MRI, Gene mutation

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