Amide Proton Transfer Weighted MR Imaging for Predicting Meningioma Stiffness: A Feasibility Study

摘要

Background Stiffness of meningioma is an important factor affecting the surgical resection and the prognosis of patients. Purpose To examine the feasibility of APTw-magnetic resonance imaging (MRI) in evaluating meningioma stiffness. Study Type Retrospective. Population Seventy-one patient with meningiomas, 39 were male and 32 were female; the mean age was 51 +/- 10 years. Field Strength/Sequence 3.0T; Turbo-spin-echo T-1-weighted and Gd-T-1-weighted sequence; Turbo-spin-echo T-2-weighted sequence; 2D fat-suppressed, turbo-spin-echo APTw pulse sequence. Assessment The T1WI signal intensity score, T2WI signal intensity score, APTw(min), APTw(max), and APTw(mean) values were compared between soft, medium stiff and stiff meningiomas or non-stiff meningiomas and stiff meningiomas group. Statistical Tests Chi-square test, one-way ANOVA analysis, independent-samples t-test, intra-class correlation coefficient, rank-sum test, receiver operating characteristic curve analysis. P < 0.05 was considered statistically significant in all tests. Results APTw(min) and APTw(mean) in the stiff group were significantly lower than that in the non-stiff group (2.79% +/- 0.42% vs. 1.90% +/- 0.60% and 3.20% +/- 0.31% vs. 2.55% +/- 0.61%). APTw(min) and APTw(mean) in the stiff group were significantly lower than that in the medium stiff and soft groups (1.90% +/- 0.60% vs. 2.69% +/- 0.40% and 3.12% +/- 0.32%, 2.55% +/- 0.61% vs. 3.17% +/- 0.33% and 3.39% +/- 0.18%), APTw(min) in the medium stiff group was significantly lower than in the soft group, there was no significant difference in APTw(mean) between the medium stiff and soft groups (P = 0.190). APTw(min) showed the best diagnostic performance for evaluating meningioma stiffness with an area under the curve of 0.913, when the APTw(min) was lower than 2.4%, the meningioma was defined as a stiff tumor, the sensitivity, specificity, and accuracy were 87.1%, 87.5%, and 85.9%, respectively. Data Conclusion APTw-MRI could be used to evaluate meningioma stiffness, with APTw(min) having the best evaluative efficiency. Level of Evidence 3 Technical Efficacy Stage 1

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