| Purpose:To investigate the value of dynamic susceptibility contrast-enhanced MRI(DSC-MRI)to predict prognosis in patients with gliomas.Methods:We conducted a retrospective analysis of the preoperative perfusion MR imaging in62 histologically confirmed gliomas.All patients underwent MRI routine scan,enhanced scan and DSC scan before operation and got radiotherapy,adjuvant chemotherapy,concurrent radiochemotherapy and cranial MRI regular follow-ups at our hospital.OS was evaluated from the date of histopathological diagnosis to death or the last available follow-up.We drawed ROI by hands to obtain the r CBVmax value at the tumor solid area.Median relative CBV values were selected for quantitative analysis.Survival analysis was made by constructing survival curves using the Kaplan-Meier method with subgroups compared by log-rank probability tests.A Cox regression model was made for multivariate analysis.Results:(1)Kaplan-Meier survival curves demonstrated that overall survival of high r CBVmax(≥4.47)was significantly shorter than that of low r CBVmax(﹤ 4.47)(P ﹤0.001),overall survival of low-grade glioma was significantly longer than that of high–grade glioma(P =0.001).Incooperating r CBVmax and pathological grade,the prognosis was best for the group of LGG+r CBVmax ﹤ 4.47 and worst for the group of HGG+r CBVmax≥4.47.No significant difference was found between the group of LGG+r CBVmax≥4.47 and HGG+r CBVmax﹤4.47(P=0.154).(2)Multivariate analysis suggested that r CBVmax was associated with survival independent of pathology(P =0.001).In addition,the result showed that age,pathological grade and the extent of surgical resection were also associated with survival independently.Conclution:The rCBVmax value can be seen as an independent indicator of prognosis in patients with glioma and serve as an adjunct to WHO grading to determine clinical individual treatment. |
PDF Full Text Request