| Brain gliomas have the highest incidence in intracranial malignant tumors.the degree of malignance and invasion of gliomas are related closely to the clinical diagnosis and treatment, together with the evaluation of recurrence and prognosis. By conventional CT and MRI, determination of the definitive diagnosis and the degree of malignance are mainly according to morphology such as uniformity of tumor, cystis degeneration, necrosis inside and hemorrhage, the borders, mass effect, the degree of peri-tumour edema, the feature and degree of enhancement et al. Recently 1H-MRS were extensively applied to brain gliomas,which improve the evaluation of biological characteristic of gliomas at molecular level.1H-MRS (1H magnetic resonance spectroscopy) has been shown to be an effective and noninvasive diagnostic tool that could be used to monitor serially biochemical and metabolic changes during the disease process of brain disorder. Metabolic information about normal and pathologic tissue can be obtained noninvasively to fill up the shortage of morphologic information provided by other imaging techniques including routine CT and MRI. 1H-MRS may be useful for differential diagnosing train diseases,Its development has made it possible to obtain biochemical and metabolic information of human brain tissue,and discriminate tumorous and nontumorous pathological changes,as well as various tissue types of train tumor. Thus,1H-MRS has now become a new clinical diagnosis tool,which has been widely applied in patients with various disorders including tumors, demyelinating disease, infarcts,encephalitis, epileptic seizure, and so on .In this study, we carried out retrospective analysis on 29 patients with brain gliomas from January, 2005 to December, 2006 in the third hospital, Jilin university, which has been confirmed through surgical-pathology or clinical diagnosis. Based on the pathologic results .these cases were divided into four groups, consisting of poorly differentiated gliomas(WHO gradeâ… ,â…¡)and well differentiated gliomas(WHO gradeâ…¢,â…£), the edema and non-edemata group around tumor basing on peri-tumoral edematous condition. Control group consists of normal brain tissue of 15 volunteers. The ratio of NAA/Cr, Cho/Cr and NAA/Cho in the normal brain, tumors and area around tumors were measured and calculated through 1H-MRS, and the variability of datas were examined with statistical analysis. The objective of this article is to explore the correlation between the characteristic of 1H-MRS and the pathological grading, tumor invasion of gliomas, to evaluate the clinical value of 1H-MRS in preoperative diagnosis of brain gliomas, differential diagnosis, pathological grading, treatment perscription et al.In poorly differentiated and well differentiated gliomas, there were significant difference of the ratios of NAA/Cr, NAA/Cho and Cho/Cr between the tumoral tissues, The ratio of of NAA/Cr, NAA/Cho and Cho/Cr between the tumoral tissues, the peri-tumoral tissues and the normal brain of control group examined with statistical analysis have significant differences (P<0.05). Significant difference between poorly differentiated and well differentiated gliomas were found in the ratios of NAA/Cr, NAA/ Cho and Cho/Cr (P<0.05). whether edema or not, there were significant difference of the ratios of NAA/Cr and NAA/Cho between the tumoral tissues, the peritumoral tissues and the normal brain of control group (P<0.05), but there were no significant difference of the ratios of Cho/Cr between the peritumoral tissues of nonedemagroup and the normal brain of control group(P>0.05). No significant difference between the tumoral the peri-tumoral edema group and tissues of the peri-tumoral nonedema group were found in the ratios of NAA/Cr, NAA/Cho and Cho/Cr (P>0.05). the ratio of NAA/Cr, NAA/Cho and Cho/Cr between the tumoral and the peri-tumoral tissue in edema group have no significant differences through statistical analysis. There were no significant difference of the ratios of NAA/Cr and Cho/Cr between peri-tumoral tissues of edema group and the nonedema group (P>0.05), but the ratios of NAA/Cho have statistical significance (P<0.05). Therefore there were significant correlations between the ratios of NAA/Cr, NAA/Cho and Cho/Cr and the pathological grading of gliomas. whether the grade is high ,and there is edema or not , 1H-MRS could evaluate the character of gliomas, and invasive information around tumor tissue.In conclusion, 1H-MRS could reflect character of gliomas at molecular level, evaluate diagnostic accuracy, and evaluate pathologic grading and invasive information around tumor tissue. It is helpful for planning treatment of gliomas.
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