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Цель исследования: оценить корреляцию Ki-67/ MIB-1 LI и степень злокачественности глиом головного мозга с параметрами диффузионно-куртозисной МРТ (ДК-МРТ) в опухоли. Материал и методы. В исследование включено 84 пациента с супратенториальными глиомами головного мозга (35 глиом низкой, 20 глиом III и 29 глиом IV степени злокачественности). Оценена корреляционная связь абсолютных и нормализованных параметров диффузионного тензора (средняя, аксиальная и радиальная диффузия (MD, AD, RD), фракционной и относительной анизотропии (FA и RA)), диффузионного куртозиса (средний, аксиальный и радиальный куртозис (MK, AK, RK), куртозисной анизотропии (KA)) с Ki-67/MIB-1 LI и степенью злокачественности глиом в их наиболее злокачественных участках (p 0,05, коэффициент Спирмена). Результаты. Параметры ДК-МРТ показали статистически значимую корреляцию с Ki-67/MIB-1 LI и степенью злокачественности глиом. Наличие олигодендроглиального компонента в глиомах (в олигодендроглиомах (ОлДГ) и олигоастроцитомах (ОлАСЦ)) не повлияло на корреляцию параметров ДК-МРТ с Ki-67/MIB-1 LI, однако повлияло на корреляцию параметров ДК-МРТ со степенью злокачественности глиом. При изучении корреляции параметров ДК-МРТ с Ki-67/MIB-1 LI у глиом grade IV максимальная корреляция была найдена у нормализованной куртозисной анизотропии. Заключение. ДК-МРТ показала высокую чувствительность в выявлении структурных изменений в глиомах, которые наблюдаются при изменении степени злокачественности и Ki-67/MIB-1 LI опухоли. Параметры ДК-МРТ зависят от степени злокачественностии Ki-67/ MIB-1 LI глиом. Наличие олигодендроглиального компонента в глиомах не влияет на корреляцию параметров ДК-МРТ с Ki-67/MIB-1 LI, однако влияет на корреляцию параметров ДК-МРТ со степенью злокачественности глиом. Комплексный анализ параметров ДК-МРТ в глиомах с учетом степени злокачественности, Ki-67/MIB-1 LI и наличия олигодендроглиального компонента в опухоли, проведенный в нашей работе, позволил углубленно изучить параметры ДК-МРТ при различных патологических процессах, развивающихся в опухоли.
Ключевые слова:
диффузионный тензор, диффузионный куртозис, глиома, злокачественность, diffusion tensor, diffusion kurtosis, glioma, malignancy grade
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Purpose: to assess correlation between Ki-67/MIB-1 LI and WHO grade brain gliomas and parameters of diffusion kurtosis MRI (DK-MRI) in the tumor. Patients and methods. The study includes 84 patients with supratentorial brain gliomas (35 gliomas with low grade malignancy, 20 gliomas with the 3-rd grade and 29 gliomas with the 4-th grade of malignancy). The study appraised correlation links between absolute and normalized parameters of diffusion tensor (mean, axial and radial (MD, AD, RD), fractional and relative anisotropy (FA and RA) and diffusion kurtosis (mean, axial and radial (MK, AK, RK), kurtosis anisotropy (KA)) with Ki-67/MIB-1 LI and WHO glioma grade in the most malignant regions (p 0.05, Spirman coefficient). Results. DK-MRI parameters showed statistically significant correlation with Ki-67/MIB-1 LI and WHO glioma grades. Presence of oligodendroglioma (ODG) component in gliomas and oligoastrocytomas (OASs) did not affect the correlation between DK-MRI parameters and Ki-67/MIB-1 LI. However it affected correlation between DK-MRI parameters and WHO glioma grades. When studying correlation between parameters of DK-MRI and Ki-67/MIB-1 LI in IV grade gliomas maximum correlation was detected in case of normalised kurtosis anisotropy (KA). Conclusion. DK-MRI proved high sensitivity in detecting structural changes in gliomas, which are observed when WHO grade and Ki-67/MIB-1 LI tumors change. DK-MRI parameters depend on WHO grade and Ki-67/MIB-1 LI gliomas. Presence of oligodendroglioma component in gliomas does not affect the correlation between DK-MRI parameters and Ki-67/MIB-1 LI, but affect the correlation between DK-MRI parameters and WHO glioma grade. Complex analysis of DK-MRI parameters in gliomas with due account for WHO glioma grade, Ki-67/MIB-1 LI and presence of oligodendroglioma component in the tumor carried out in our study made it possible to study in depth the dynamics of DK-MRI parameters during various pathological processes developing in the tumor.
Keywords:
диффузионный тензор, диффузионный куртозис, глиома, злокачественность, diffusion tensor, diffusion kurtosis, glioma, malignancy grade