河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (1): 74-80.doi: 10.3969/j.issn.1007-3205.2023.01.015

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DWI、IVIM参数与脑胶质瘤患儿肿瘤标志物水平相关性

  

  1. 1.广东省广州市妇女儿童医疗中心介入血管瘤科,广东 广州 510120;2.广东省广州市妇女儿童医疗中心神经外科,
    广东 广州 510120;3.广东省广州市妇女儿童医疗中心麻醉科,广东 广州 510120

  • 出版日期:2023-01-25 发布日期:2023-01-17
  • 作者简介:黄晓明(1979-),男,广西柳州人,广东省广州市妇女儿童医疗中心主管技师,医学硕士,从事介入血管瘤诊治研究。
  • 基金资助:
    广州市科技计划项目(19-HDWS-016)

Correlation of DWI and IVIM parameters with tumor marker levels in children with gliomas

  1. 1.Department of Interventional Hemangioma, Guangzhou Women and Children′s Medical Center, 
    Guangdong Province, Guangzhou 510120, China; 2.Department of Neurosurgery, Guangzhou Women 
    and Children′s Medical Center, Guangdong Province, Guangzhou 510120, China; 3.Department of 
    Anesthesiology, Guangzhou Women and Children′s Medical Center, Guangdong Province, 
    Guangzhou 510120, China

  • Online:2023-01-25 Published:2023-01-17

摘要: 目的  探究扩散加权成像(diffusion weighted imaging,DWI)、体素不相干运动扩散加权成像(diffusion-weighted imaging of voxel incoherent motion,IVIM)参数与脑胶质瘤患儿肿瘤标志物水平相关性及诊断价值。
方法  选取于我院进行诊断的疑似脑胶质瘤患儿89例,以病理检查为金标准,最终确诊脑胶质瘤患儿62例为观察组,其余27例为对照组。所有研究对象均进行DWI技术、IVIM技术检查,酶联免疫吸附实验法检测糖链抗原125(carbohydrate antigen 125,CA125)、表皮生长因子(epidermal growth factor,EGF)、癌胚抗原(carcinoembryonic antigen,CEA)水平,对比不同病情患儿表观弥散系数(apparent dispersion coefficient,ADC)、相对脑血容量( relative cerebral blood volume, rCBV)、真实水分子弥散系数(true water molecular dispersion coefficient,D)、血流灌注相关弥散系数(D*)水平及CA125、EGF、CEA水平;对比各指标与病情类型的相关性;对比脑胶质瘤患儿DWI、IVIM参数与肿瘤标志物水平相关性;分析DWI、IVIM参数对脑胶质瘤的诊断价值。
结果  与对照组比较,观察组研究对象ADC值、D参数水平较高,rCBV、D*参数水平较低(P<0.05)。与低级别脑胶质瘤患儿比较,高级别脑胶质瘤患儿ADC值、D参数水平及血清CA125、EGF、CEA水平较高,rCBV、D*参数水平较低(P<0.05)。脑胶质瘤患儿rCBV、D*水平与病情类型呈负相关(r=-0.395,P<0.001;r=-0.405,P<0.001),ADC值、D、CA125、EGF、CEA水平与病情类型呈正相关(r=0.432,P<0.001;r=0.441,P<0.001;r=0.432,P<0.001;r=0.409,P<0.001;r=0.431,P<0.001);ADC值(r=0.409,P<0.001;r=0.415,P<0.001;r=0.423,P<0.001);D参数与肿瘤标志物CA125、EGF、CEA水平呈正相关(r=0.417,P<0.001;r=0.43,P<0.001;r=0.409,P<0.001);rCBV值与肿瘤标志物CA125、EGF、CEA水平呈负相关(r=-0.402,P<0.001;r=-0.413,P<0.001;r=-0.387,P<0.001);D*水平与肿瘤标志物CA125、EGF、CEA水平呈负相关(r=-0.411,P<0.001;r=-0.406,P<0.001;r=-0.399,P<0.001)。与ADC值、rCBV、D、D*相比,四项联合诊断对脑胶质瘤诊断效能较高(P<0.05)。
结论  DWI、IVIM参数与脑胶质瘤患儿肿瘤标志物水平具有一定相关性,对脑胶质瘤患儿病情类型具有一定诊断价值。


关键词: 脑胶质瘤, 扩散加权成像, 肿瘤标志物

Abstract: Objective  To investigate the correlation of diffusion-weighted imaging (DWI), and intravoxel incoherent motion diffusion-weighted imaging (IVIM) parameters with tumor marker levels in children with glioma and their diagnostic value. 
Methods  A total of 89 children with suspected glioma diagnosed in our hospital were selected. With pathological examination as the gold standard, 62 children with definitive diagnosis of glioma were selected as the observation group, and the remaining 27 children were selected as the control group. All subjects were examined by DWI and IVIM, and the levels of carbohydrate antigen 125 (CA125), epidermal growth factor (EGF) and carcinoembryonic antigen (CEA) were detected by enzyme-linked immunosorption assay (ELISA). The levels of apparent dispersion coefficient (ADC), relative cerebral blood volume (rCBV), true water molecular dispersion coefficient (D), perfusion related dispersion coefficient (D*), CA125, EGF and CEA levels were compared in children with different conditions. The correlation between each indicator and the disease type was compared. The correlation between DWI, IVIM parameters and tumor markers in children with glioma was compared. The diagnostic value of DWI and IVIM parameters in glioma was analyzed. 
Results  Compared with the control group, the ADC value and D parameters of the observation group were higher, while the rCBV and D* parameters were lower (P<0.05). Compared with children with low-grade glioma, children with high-grade glioma had higher ADC values, D parameters and serum CA125, EGF and CEA levels, but lower rCBV and D* parameters (P<0.05). The levels of rCBV and D* were negatively correlated with the type of disease (r=-0.395, P<0.001; r=-0.405, P<0.001), while ADC value, D, CA125, EGF, CEA levels were positively correlated with disease type (r=0.432, P<0.001; r=0.441, P<0.001; r=0.432, P<0.001; r=0.409, P<0.001; r=0.431, P<0.001); ADC value (r=0.409, P<0.001; r=0.415, P<0.001; r=0.423, P<0.001); D parameter was positively correlated with the levels of tumor markers CA125, EGF and CEA (r=0.417, P<0.001; r=0.43, P<0.001; r=0.409, P<0.001); RCBV was negatively correlated with the levels of tumor markers CA125, EGF and CEA (r= -0.402, P<0.001; r=-0.413, P<0.001; r=-0.387, P<0.001); D* level was negatively correlated with the levels of tumor markers CA125, EGF and CEA(r=-0.411, P<0.001; r=-0.406, P<0.001; r=-0.399, P<0.001). Compared with ADC value, rCBV, D and D *, the combined detection of the four indicators was more effective in the diagnosis of glioma (P<0.05). 
Conclusion  DWI and IVIM parameters have certain correlation with tumor markers in children with glioma, and have certain diagnostic value for the disease types of children with glioma.


Key words: glioma, diffusion weighted imaging, tumor marker