为了研究空间复发模式与患者预后的关联，并确定MRI血管生境是否能预测空间模式。在这项回顾性研究中，纳入了69例局部复发高级别胶质母细胞瘤（HGGs）的患者。根据复发肿瘤位置与切除腔或手术区域之间的距离，将队列划分为切除腔内复发（ICR）和切除腔外复发（ECR）模式。对高血管新生瘤、低血管新生瘤、渗透性外周水肿和渗透性外周水肿等四种血管生境进行分割，并分析血管异质性参数。通过Kaplan-Meier和ROC分析不同空间复发模式下的生存和诊断性能。通过回归分析构建了一个判别模型，并通过自举法进行验证。ICR（n = 32）的无进展生存期（PFS）和总体生存期（OS）较ECR（n = 37）更长（中位PFS：8个月与5个月，中位OS：17个月和13个月，p <0.05）。MRI血管生境分析显示ECR在每个生境中的中位相对脑血流量（rCBV中位）均高于ICR（所有p <0.01）。IPE的rCBV中位数具有良好的诊断性能（AUC：0.727，95％CI：0.607, 0.828）。基于MRI血管生境和临床因素的判别模型的AUC为0.834（95％CI：0.726，0.913），并通过自举法验证确认为0.833（95％CI：0.830，0.836）。局部复发HGGs的空间模式与预后有关。基于MRI血管异质性参数的非侵入性成像标记可用于预测空间复发模式。基于MRI血管生境分析的血管异质性参数可非侵入性地预测局部复发高级别胶质母细胞瘤的空间模式，为临床医生制定手术切除范围和术后放疗计划提供了新的诊断依据。• 切除腔内模式与局部复发高级别胶质母细胞瘤的较长无进展生存期和总体生存期相关。• 切除腔外复发的血管异质性较切除腔内复发更高，并且血管异质性参数在鉴别空间复发模式方面具有良好的诊断性能。• 基于MRI血管生境和临床因素的判别模型在预测空间复发模式方面具有良好的性能。© 2023年。作者。

To investigate if spatial recurrence pattern is associated with patient prognosis, and whether MRI vascular habitats can predict spatial pattern.In this retrospective study, 69 patients with locally recurrent high-grade gliomas (HGGs) were included. The cohort was divided into intra-resection cavity recurrence (ICR) and extra-resection cavity recurrence (ECR) patterns, according to the distance between the location of the recurrent tumor and the resection cavity or surgical region. Four vascular habitats, high angiogenic tumor, low angiogenic tumor, infiltrated peripheral edema, and vasogenic peripheral edema, were segmented and vascular heterogeneity parameters were analyzed. The survival and diagnostic performance under different spatial recurrence patterns were analyzed by Kaplan-Meier and ROC. A nomogram model was constructed by regression analysis and validated by bootstrapping technique.Progression-free survival (PFS) and overall survival (OS) were longer for ICR (n = 32) than those for ECR (n = 37) (median PFS: 8 vs. 5 months, median OS: 17 vs. 13 months, p < 0.05). MRI vascular habitat analyses showed ECR had higher median relative cerebral blood volume (rCBVmedian) at each habitat than ICR (all p < 0.01). The rCBVmedian at IPE had good diagnostic performance (AUC: 0.727, 95%CI: 0.607, 0.828). The AUC of the nomogram based on MRI vascular habitats and clinical factors was 0.834 (95%CI: 0.726, 0.913) and was confirmed as 0.833 (95%CI: 0.830, 0.836) by bootstrapping validation.The spatial pattern of locally recurrent HGGs is associated with prognosis. MRI vascular heterogeneity parameter could be used as a non-invasive imaging marker to predict spatial recurrence pattern.Vascular heterogeneity parameters based on MRI vascular habitat analyses can non-invasively predict the spatial patterns of locally recurrent high-grade gliomas, providing a new diagnostic basis for clinicians to develop the extent of surgical resection and postoperative radiotherapy planning.• Intra-resection cavity pattern was associated with longer progression-free survival and overall survival in locally recurrent high-grade gliomas. • Higher vascular heterogeneities in extra-resection cavity recurrence than in intra-resection cavity recurrence and the vascular heterogeneity parameters had good diagnostic performance in discriminating spatial recurrence pattern. • A nomogram model based on MRI vascular habitats and clinical factors had good performance in predicting spatial recurrence pattern.© 2023. The Author(s).