Görsel kalitatif DW görüntüleme, ADC kantifikasyonu ve Ki-67 proliferasyon indeksinin referans

Year 2018, , 68 - 75, 06.04.2018

Baran Yilmaz Süleyman Sener Hasanaov Teyyub Akın Akakın Özlem Yapıcıer Mustafa Kemal Demir

https://doi.org/10.5472/marumj.413158

Abstract

Amaç:  Bu çalışmada amacımız, intrakranyal
meningiomların derecelendirmesinde görsel kalitatif DW görüntüleme, ADC
kantifikasyonu ve Ki-67 proliferasyon indeksinin referans standart
histopatoloji ile karşılaştırıldığında etkinliğini araştırmaktır.

Gereç ve
Yöntem:  Patolojisi meningiom olarak
rapor edilmiş toplam 35 hastamızın, konvansiyonel MR görüntülemeleri,
kontrastlı MR görüntülemeleri, DW görüntülemeleri ve ADC haritaları
arşivimizden elde edilmiştir.

Bulgular:
Sekiz hastada (23%) atipik (5 kadın ve 3 erkek; ortalama yaş: 57.1±15.8 yıl);
27 hastada ise (77%) düşük dereceli tipik meningiom (19 kadın, 8 erkek;
ortalama yaş: 54.3±14.0 yıl) vardı. Hem (59%) en sık histolojik alttip
meningotelyal tip idi. Ki-67 proliferasyon indeksi, düşük dereceli ve atipik
meningiomlarda sırasıyla 2.31±1.44% (aralık: 1-5) and 7.37 ± 2.72% (aralık:
3-10) olarak saptandı. Görsel kalitatif değerlendirmede, difüzyon kısıtlanması
atipi meningiomlarda daha belirgindi (p<0.05). Kantitatif değerlendirmede,
ADC değerlerinde heriki grup arasında anlamlı fark saptanmadı (p=0.471).

Sonuç :
Görsel kalitatif DW görüntüleme değerlendirmesinin, atipi ve cerrahi tedavi
uygulanmış meningiom hastalarında tekrarlama riskinin tahmininde yardımcı
olabileceğini önermekteyiz.

Keywords

difüzyon ağırlıklı görüntüleme, meningiom, cerrahi, histopatoloji

Visual qualitative evaluation of diffusion-weighted imaging, apparent diffusion coefficient quantification and Ki-67 proliferation index for predicting atypia in surgical meningiomas

Abstract

Object. The goal in this study was to investigate the
efficiency of qualitative evaluation using DW imaging, ADC quantification, and Ki-67 proliferation labeling index in grading
intracranial meningiomas compared to our reference standard histopathology.

Methods.
From our database, we enrolled 35 consecutive patients
with pathologic report of a meningioma, conventional
MR imaging, contrast-enhanced MR imaging, DW imaging and ADC maps.

Results.
Eight patients (23%) had atypical
meningioma (5 women and 3 men; mean age: 57.1±15.8
years); 27 (77%) had low-grade-typical (19 women, 8 men; mean age: 54.3±14.0 years). The most frequent histological subtype
was the meningothelial type in both low-grade (37%) and atypical meningiomas
(59%). The mean Ki-67 proliferation index for low-grade and atypical
meningiomas were 2.31±1.44% (range: 1-5) and 7.37 ±
2.72% (range: 3-10), respectively. Meningiomas
with Ki-67 proliferation index higher than 4% (except one) were atypical
(p<0.001). In visual qualitative evaluation;
diffusion restriction was significantly
more common in atypical meningiomas (p<0.05). In
quantitative evaluation, benign and atypical tumor
groups had no significant difference in mean ADC values (p=0.471).

Conclusion.
We suggest that visual qualitative
evaluation of DW imaging may be helpful to predict atypia and the risk of
recurrence in patients with surgically treated meningiomas.

Keywords

diffusion weighted imaging, meningioma, surgery, histopathology

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