| Objective To explore the applicative value of 3.0T MRI diffusion tensor imaging in the diagnosis of intracranial tumors, incuding tumorous showing, pathological grading, prediction of peritumoral infiltration and the relationship between brain tumors and white matter fiber bundles.Materials and Methods The study object is the patients who were diagnosed as intracranial tumors between octorber 2008 and November 2009 in the First affiliated hospital of guangxi medical university.42 patients underwent routine MRI, DTI, and contrast-enhanced scanning. Measured FA values in tumoral parenchyma, peritumoral edema, outer of the white matter region of edema and the corresponding part of the quality of contralateral mirror site, and calculated the rFA value. Analysised the statistical difference of FA and rFA values in parenchyma, peritumoral edema, outer of the white matter region of edema in the same or different tumor. Study FA and rFA values of tumoral parenchyma as the threshold in high and low grade gliomas. Reconstructed fiber bundles, discussed the relationship between intracranial tumor and the anatomical structure of white matter fiber.t-test was employed for the same kind of tumor group comparison. Analysised the variance between different tumor with ONE WAY ANOVA, when variance arrhythmias with LSD or SNK. All calculations were performed with SPSS software version 16.0. Ap value of less than 0.05 was considered to represent a statistically significant difference in all cases.Results 42 intracranial tumors were pathologically confirmed.31 cases of glioma,14 low-grade gliomas,17 high-grade gliomas; 5 metastatses; 6 meningiomas. Solid part of all tumors showed mixed signal on the FA map, the FA values in a decreasing order, meningiomas (0.178±0.012), low-grade gliomas (0.146±0.073), high-grade gliomas (0.120±0.070), metastasis (0.081±0.075). The statistically significant differences with FA values were found in the same tumoral parenchyma, peritumoral edema and outer of the white matter region of edema (p<0.001). The FA values in solid tumor components between the four kinds of tumor were statistically significant difference (p=0.000). The FA values in peritumoral edema between high-grade gliomas and metastasis, meningiomas and low-grade gliomas were no difference (p=0.850,0.362). The FA values in outer of the white matter region of edema between high-grade gliomas and metastasis were no difference (p=0.204). The statistically differences with rFA values were found in parenchyma and peritumoral edema between high-grade gliomas and low-grade gliomas, low-grade gliomas and malignant tumors (p<0.05); The rFA values of parenchyma in low-grade gliomas and meningiomas had no difference (p=0.150); The rFA values of peritumoral edema in high-grade gliomas and metastasis (p=0.794), low-grade gliomas and meningiomas (p=0.878) had no difference. There weren't any difference with rFA values in edema aside between malignant tumors and low-grade gliomas (p=0.974). The abnormality on DTI showed wider lesion than that seen on traditional MRI images in 11/31 patients with gliomas, whereas no difference was found in abnormality of DTI between meningiomas and metastases. The position and morphology of fiber bundle in 4 meningiomas and 4 low-grade gliomas had no change; 2 meningiomas,10 low-grade gliomas,6 high-grade gliomas and 4 metastatic tumors showed displacement of white matter fiber tracts; 11 malignant tumors with white matter damage.Conclusion 1, FA values can identify parenchyma in meningioma, low-grade glioma, high-grade glioma and metastase.2, The rFA values between high-grade gliomas and low-grade gliomas, low-grade gliomas and malignant tumors in the parenchyma, edema were statistically difference (p<0.05).3, FA value 0.142 and rFA value 0.4812 can be the threshold of the high and low grade gliomas, FA value had higher accuracy at 74.19%.4, Tractography help to distinguish from benign and malignant brain tumors, malignant tumors were more susceptible to erosy and destruct the adjacent fibers. Tractogrpahy can be as an important guide to avoid injury of white matter fibers on operation. |
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