摘要
目的探讨液体衰减反转恢复序列(FLAIR)高信号环对异柠檬酸脱氢酶(IDH)突变型星形细胞瘤的诊断意义。方法回顾性分析首都医科大学附属北京天坛医院神经外科2013年12月至2020年12月收治的585例较低级别(世界卫生组织2~3级)胶质瘤(LGG)患者的临床资料。评价T2-液体衰减反转恢复序列(FLAIR)不匹配和FLAIR高信号环在诊断IDH突变型星形细胞瘤中的灵敏度和特异度。结合病变的钙化特征,整合评价病变FLAIR高信号环在诊断IDH突变型星形细胞瘤中的应用价值。结果585例LGG患者中,FLAIR高信号环仅出现在IDH突变型星形细胞瘤(71.3%,186/261)中,而未见于少突胶质细胞瘤和IDH野生型胶质瘤患者中。T2-FLAIR不匹配诊断星形细胞瘤的灵敏度为0.52,特异度为1.00;FLAIR高信号环的灵敏度为0.71,特异度为1.00。钙化主要出现在少突胶质细胞瘤中(85.8%,115/134)。在非钙化的LGG中,T2-FLAIR不匹配诊断星形细胞瘤的灵敏度为0.54,FLAIR高信号环为0.74,特异度均为1.00。结论FLAIR高信号环是诊断星形细胞瘤高灵敏度和特异性的影像学标志;结合钙化特征,可进一步提高其诊断灵敏度。
Objective To investigate the diagnostic significance of hyperintense fluid-attenuated inversion-recovery(FLAIR)rim(hyperFLAIRrim)sign for isocitrate dehydrogenase(IDH)mutant 1p/19q non-codeleted(IDHmut-Noncodel)astrocytoma.Methods A total of 585 lower-grade glioma(LGG)(World Health Organization grade 2-3)patients who received craniotomy at the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University from December 2013 to December 2020 were included in this study and their clinical data were retrospectively analyzed.The sensitivity and specificity of T2-FLAIR mismatch and hyperFLAIRrim sign were evaluated.Besides,calcification information was assessed for subgroup analysis.The application value was further determined combined with the calcification information.Results In 585 qualified patients,71.3%(186/261)of IDHmut-Noncodel astrocytomas were hyperFLAIRrim positive,and hyperFLAIRrim sign was absent in oligodendrogliomas and IDH wild-type LGGs.The sensitivity for T2-FLAIR mismatch and hyperFLAIRrim sign was 0.52 and 0.71,respectively,and the specificity was 1.00 for both.For all calcific tumors,85.8%(115/134)were oligodendroglioma.And the sensitivity of T2-FLAIR mismatch and hyperFLAIRrim sign in non-calcific tumors was 0.54 and 0.74,respectively,and the specificity of 1.00 for both.Conclusions The hyperFLAIRrim sign seems more sensitive for IDHmut-Noncodel astrocytoma without compromised specificity.Combining calcification could further improve the diagnosis sensitivity.
作者
李铭孝
陈绪珠
沈少平
杨传维
张小康
崔勇
任晓辉
林松
Li Mingxiao;Chen Xuzhu;Shen Shaoping;Yang Chuanwei;Zhang Xiaokang;Cui Yong;Ren Xiaohui;Lin Song(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Beijing Neurosurgical Institute,Capital Medical University,Beijing 100070,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2022年第9期873-877,共5页
Chinese Journal of Neurosurgery
基金
国家自然科学基金(81771309)
首都卫生发展科研专项(2022-2-1072)。
