Difuzioni koeficijent u proceni stepena maligniteta cerebralnih glioma

  • Jelena Ignjatović Faculty of Medicine, University of Niš, Niš, Serbia
  • Dragan Stojanov Faculty of Medicine, University of Niš, Niš, Serbia
  • Vladimir Živković Ministry of Defence, Belgrade, Serbia
  • Srđan Ljubisavljević Faculty of Medicine, University of Niš, Niš, Serbia
  • Nebojša Stojanović Faculty of Medicine, University of Niš, Niš, Serbia
  • Ivan Stefanović Faculty of Medicine, University of Niš, Niš, Serbia
  • Daniela Benedeto-Stojanov Faculty of Medicine, University of Niš, Niš, Serbia
  • Nebojša Ignjatović Faculty of Medicine, University of Niš, Niš, Serbia
  • Slađana Petrović Faculty of Medicine, University of Niš, Niš, Serbia
  • Aleksandra Aracki-Trenkić Center of Radiology, Clinical Center of Niš, Niš, Serbia
  • Zoran Radovanović
  • Lazar Lazović Center of Radiology, Clinical Center of Niš, Niš, Serbia
DOI: https://doi.org/10.2298/5817
Ključne reči: glioma||, ||gliom, diffusion magnetic resonance imaging||, ||magnetna rezonanca, difuziona, diagnosis||, ||dijagnoza, neoplasm staging||, ||neoplazme, određivanje stadijuma,

Sažetak


Uvod/Cilj. Magnetna rezonanca (MRI) je ključni modalitet ne samo za dijagnostiku lezija, već i za procenu tipa i gradusa tumora i stepena širenja u okolno tkivo. Savremene MRI tehnike, kao što je diffusion-weighted imaging (DWI), obezbeđuje fiziološke informacije o tumoru, dopunjujući anatomske informacije dobijene na konvencionalnom MRI. Cilj naše studije bio je da se utvrdi da li postoji korelacija mape prividnog difuzionog koeficijenta (ADC) i patohistološkog nalaza, i da li ADC koeficijent može napraviti razliku između niskogradusnih i visokogradusnih glioma. Metode. Ovom retrospektivnom studijom bilo je obuhvaćeno 25 bolesnika, kod kojih je urađen MRI pregled do sedam dana pre operacije, prema standaradnom protokolu sa sledećim sekvencama: T1WI, T2WI, FLAIR, DWI i postkontrastna T1WI. Podaci dobijeni od DW MRI predstavljeni su merenjem vrednosti ADC koeficijenta. ADC mapa je određivana korišćenjem Diffusion-Perfusion (DP) Tools softvera. Svi bolesnici bili su podvrgnuti hirurškoj resekciji tumora. Histološka klasifikacija tumora izvršena je prema kriterijumima Svetske zdravstvene organizacije. Dobijene ADC vrednosti upoređivane su sa patohistološkim nalazom tumora. Rezultati. Vrednost ADC koeficijenta astrocitoma gradus I (0,000614 ± 0,000032 mm2/s) bila je statistički značajno viša (< 0,001) od vrednosti ADC koeficijenta anaplastičnog astrocitoma (0,000436 ± 0,000016 mm2/s) i glioblastoma multiforme (0,000070 ± 0,000008 mm2/s). Vrednosti ADC koeficijenta astrocitoma gradusa II (0,000530 ± 0,000114 mm2/s) bila je statistički značajno viša (< 0,001) od vrednosti ADC koeficijenta anaplastičnog astrocitoma (0,000436 ± 0,000016 mm2/s) i glioblastoma multiforme (0,000070 ± 0,000008 mm2/s). Vrednosti ADC koeficijenta anaplastičnog astrocitoma (0,000436 ± 0,000016 mm2/s) bila je statistički značajno viša (< 0,001) od vrednosti ADC koeficijenta glioblastoma multiforme (0,000070 ± 0,000008 mm2/s). Astrocitom gradusa I (0,000775 ± 0,000023 mm2/s) imao je vrednost ADC koeficijenta cisticnog dela tumorskog tkiva statistički značajno višu (< 0,001) od vrednosti ADC anaplastičnog astrocitoma (0,000119 ± 0,000246 mm2/s) i glioblastoma multiforme (0,000076 ± 0,000004 mm2/s).  Vrednost ADC koeficijenta astrocitoma gradusa II (0,000511 ± 0,000421 mm2/s) je bila statistički značajno viša (< 0,001) od vrednosti ADC koeficijenta glioblastoma multiforme (0,000076 ± 0,000004 mm2/s). Zaključak. DWI sa određivanjem ADC mape može se smatrati pouzdanim dijagnostičkim sredstvom koje posredno odražava proliferaciju i malignitet glioma. Vrednost ADC mape može predvideti histopatološke rezultate tumora, razlikovati niskogradusne od visokogradusnih glioma, ali i pružiti značajne informacije za prehirurško planiranje, lečenje i prognozu bolesnika sa visokogradusnim astrocitomima.

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Objavljeno
2015/11/02
Broj časopisa
Vol. 72 Br. 10 (2015)
Rubrika
Originalni članak