GIÁ TRỊ CỘNG HƯỞNG TỪ THƯỜNG QUY VÀ KHUẾCH TÁN TRONG DỰ BÁO ĐỘ MÔ HỌC CỦA U MÀNG NÃO=The diagnostic value of conventional and diffusion-weighted magnetic resonance imaging in predicting the histological grade of meningioma

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Tác giả: Thị Bích Trâm Hà, Văn Phước Lê, Thị Thảo Như Ông

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.45977

Bộ sưu tập: Metadata

ID: 486801

Thêm vào giỏ

Đặt vấn đề: U màng não là u nguyên phát thường gặp nhất ở hệ thần kinh trung ương. Việc phân độ u màng não rất quan trọng trong việc điều trị và tiên lượng.Mục tiêu: Xác định giá trị kĩ thuật cộng hưởng từ thường quy và cộng hưởng từ khuếch tán trong phân độ mô học u màng não. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang, khảo sát cộng hưởng từ thường quy và khuếch tán ở 92 bệnh nhân có kết quả mô bệnh học sau phẫu thuật là u màng não tại bệnh viện Chợ Rẫy. Mối tương quan giữa các đặc điểm trên CHT thường quy và khuếch tán được phân tích thông qua hồi quy đa biến và đơn biến, tìm ngưỡng cắt tối ưu của hệ số khuếch tán biển kiến để phân biệt các nhóm u màng não bằng đường cong ROC.Kết quả: Ranh giới không rõ và có xâm lấn xương là những yếu tố có ý nghĩa thống kê đến việc dự báo độ mô học của u màng não trên cộng hưởng từ thường quy, với OR lần lượt là 9,0 và 4,1 (p <
0,05), khả năng dự đoán đúng độ mô học là 85,7%, độ nhạy là 66,7% và độ đặc hiệu là 90,4%,. Với điểm cắt ADC là 0,721 x10^-3 mm2/s, kỹ thuật DWI có độ nhạy 90,5%, độ đặc hiệu 72,2%, AUC=0,84
độ chính xác 86,9%. p <
0,001.Kết luận: CHT khuếch tán có độ nhạy cao hơn và độ chính xác cao hơn CHT thường quy trong dự báo độ mô học u màng nãoIntroduction: Meningiomas are the most frequent primary tumours of the central nervous system. Sufficient grading of meningiomas is important, as the clinical treatment and prognosis differ between distinct grades of tumor.Objective: To highlight conventional and diffusion-weighted magnetic resonance imaging characteristics in distinguishing benign from high-grade meningiomas (World Health Organization [WHO] grade II and III) preoperatively.Methods: A descriptive cross-sectional study, total of 92 patients with meningioma were assessed by conventional MRI and DWI. The correlation between imaging findings, histopathological grading was analyzed via univariate and multivariate logistic regression analysis. The optimal cutoff for the absolute apparent diffusion coefficient (ADC) to differentiate between the groups was determined by using receiver operating characteristic (ROC) analysis.Result: The presence of irregular tumor margins, adjacent bone invasion are predictors of higher grade meningiomas, OR = 9,0 and OR = 4,1 respectively. Conventional MRI shows 66,7% sensitivity, 90,4% specificity. ROC analysis showed that ADC thresholds of 0,721 x10^-3 mm2/s had the best accuracy, sensitivity of 90,5%, specificity of 72,2% for grading meningiomas.Conclusion: Diffusion-weighted MRI was found to have high sensitivity and accuracy to conventional MRI in distinguishing benign from high-grade meningiomas.

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