Primena lokalnih histograma prividnog difuzionog koeficijenta u diferencijaciji astrocitoma mozga
Sažetak
Uvod/Cilj. Razlikovanje atrocitoma mozga zasnovano na analizi mapa difuzijski naglašenog snimanja (DWI) predstavlja težak zadatak, što je posledica mikrostrukturne heterogenosti ovih entiteta. U ovoj studiji primenjena je histogramska analiza mapa prividnog difuzionog koeficijenta (ADC) da bi se lokalizovali regioni (ROI) koji odgovaraju maksimalnoj celularnosti tumora. Testirana je mogućnost korišćenja parametara dobijenih iz tih regiona [ADC, standardna devijacija ADC (ΔADC) i kurtozis (K)] za razkovanje različitih gradusa astrocitoma. Metode. U retrospektivnu studiju bio je uključen 31 bolesnik (16 žena i 15 muškaraca, prosečna starost 37 godina; raspon 6–72 godina) sa suspektnim supratentorijalnim astrocitomima. Pregledi magnetno rezoanantnim snimanjem (MRI) urađeni su na uređaju jačine magnetnog polja 1,5 T (Avanto; Siemens, Erlangen, Nemačka). Korišćena je 8-kanalna zavojnica za glavu. DWI snimci dobijeni su u tri međusobno normalna pravca i tri vrednosti difuzijske ostetljivosti b (0, 500 and 1000 s mm-2). Histogramska analiza i određivanje difizionih parametara izvršeno je korišćenjem MIPAV sofvera. Statistička analiza urađena je u Openstat programskom paketu. Rezultati. Ustanovljena je statistički značajna razlika između ADC vrednosti za difuzne astrocitome (DA) i visokogradusne astrocitome (HGA), ali ne i između HGA podklasa. Statistički značajne razlike nađene su i između ΔADC vrednosti za anaplastične astrocitome (AA) i glioblastome mulitforme (GBM) za 100% osetljivošću i 89% specifičnosti. K parametar takođe može poslužiti u razlikovanju AA i GBM ali sa manjom osetljivošću i specifičnošću. Zaključak. Histogramska analiza regiona tumora na ADC mapama može poslužiti kao vodič za pravilno pozicioniranje ROI. Parametri koji karakterišu difuziju na tako definisanim ROI, pojedinačno i kombinovano, mogu pomoći u diferencijaciji astrocitoma mozga.
Reference
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