Authors: Lu, Ziwei | You, Zhiqun | Xie, Daohai | Wang, Zhongling
BACKGROUND: It is difficult to distinguish solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (AM) by conventional imaging.As far as we know,diffusion weighting imaging may identify them effectively. OBJECTIVE: The purpose of this study was to determine the role of apparent diffusion coefficient (ADC) values to distinguish and predict prognosis of solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) (WHOII) and atypical meningioma (AM). METHODS: Preoperative diffusion-weighted imaging (DWI) of 30 cases with histopathologic and immunhistochemical testified SFT/HPC WHOII (n = 11) and AM (n =
…19) were performed retrospectively. The ADC values of lesion, peritumoral edema, normal white matter and lesion NADC ratio (lesion ADC values/ADC values of normal white matter (NWN ADC)) were compared. The immunhistochemical markers (Ki-67, CD34, Vim, EMA, GFAP, S-100, PR, CD56) were compared. The correlation between the ADC values and Ki-67 index was evaluated. RESULTS: The mean lesion ADC values of SFT/HPC (1.15 ± 0.04 × 10 - 3 mm 2 /s) was significantly higher than that of AM (0.80 ± 0.04 × 10 - 3 mm 2 /s) (t = 23.824, p < 0.05). The mean NADC ratio was lower for AM (1.03 ± 0.06) compared with SFT/HPC (1.51 ± 0.05) (t = 23.105, p < 0.05). The mean edema ADC for SFT/HPC (1.47 ± 0.06 × 10 - 3 mm 2 /s) was lower compared with AM (1.68 ± 0.05 × 10 - 3 mm 2 /s) (t = - 9.926, p < 0.05 ). There was no statistical difference between the two groups of NWM ADC (t = - 1.475, p > 0.05) . The mean Ki-67 of SFT/HPC (7.18 ± 2.60%) was lower than the mean Ki-67 of AM (13.58 ± 4.50%) (t = - 4.934, p < 0.05). The CD34 showed statistically differences between two groups (X 2 = 13.659, p < 0.05). The EMA also showed statistically differences between two groups (X 2 = 4.474, p < 0.05). Vim,GFAP, S-100, PR, CD56 showed no statistical difference in the two group (p > 0.05). The pearson analysis indicated that there was a negative correlation between lesion ADC and Ki-67 in SFT/HPC group (r = - 0.770, p < 0.05) and AM group (r = - 0.727, p < 0.05). There was also a negative correlation between lesion NADC ratio and Ki-67 in SFT/HPC group (r = - 0.673, p < 0.05) and AM group (r = - 0.707, p < 0.05). There was a positive correlation between edema ADC and Ki-67 in SFT/HPC group (r = 0.819, p < 0.05) and AM group (r = 0.942, p < 0.05). Furthermore,there was no correlation between NWM A DC and Ki-67 in SFT/HPC group (r = - 0.403, p > 0.05) and AM group (r = 0.202, p > 0.05). CONCLUSIONS: The lesion ADC, lesion NADC ratio and edema ADC can distinguish the SFT/HPC WHO II from AM and be helpful to predict prognosis of the two tumors before operation. Further more, histopathologic and immunhistochemical can make a definite diagnosis of the two tumors.
Keywords: Solitary of fibrous tumor/hemangiopericytoma, atypical meningioma, ADC, Ki-67, CD34, EMA
Citation: Technology and Health Care,
vol. 27, no. 2, pp. 137-147, 2019
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