Preliminary Study Of Magnetic Resonance Dynamic Contrast Enhancement (DCE-MRI) Combined With Diffusion Weighted Imaging(DWI) To Identify Glioma Recurrence And Treatment-related Changes

Objective:To investigate the value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)in identifying recurrence and treatment-related changes of glioma.Methods:Thirty-two patients with cerebral glioma resection and abnormal enhancement after radio-chemotherapy(22 patients had recurrence and 10 patients had treatment-related changes)were collected.All patients undergone routine Magnetic Resonance Imaging,enhancement,DWI,DCE imaging within 2 months after the radio-chemotherapy.Ktran,Kep,Ve,i AUC perfusion pseudo-color map and ADC map were obtained using post-processing workstation,and their values of enhancement region were also calculated separately.The differences in parameters between recurrence and treatment-related changes were evaluated using Wilcoxon test,and the receiver operating characteristic(ROC)curve was plotted to calculate sensitivity and specificity with the area under the curve.Results:The higher Ktrans and i AUC values were observed in recurrence group(P < 0.05).The area under Ktrans and i AUC curves were 0.973 and 0.941,the sensitivity and specificity were 95.5%,95.5%and 90%,80% respectively,using the threshold of 0.128 and 0.152.The recurrence group had the lower average ADC value than the treatment-related changes group(P < 0.05),and the area under the average ADC curve was 0.864(sensitivity and the specificity of 86.4% and 80%,respectively).The Ktrans value had the highest diagnostic efficacy,the sensitivity can improve to 100% on detecting recurrence when incorporating Ktrans and ADC values.Conclusion:DCE-MRI combined with DWI has important clinical value on the differential diagnosis between recurrence and treatment-related changes in glioma,and is of great value in guiding the choice of clinical treatment options and prognosis evaluation.