| Objective: To investigate the differential value of diffusion weighted imaging(DWI), perfusion weighted imaging (PWI) and proton magnetic resonancespectroscopy(1H-MRS) for the detection of viral encephalitis, intracranial tuberculosisand low-grade gliomas.Materials and Methods: The conventional MR imaging, DWI, PWI and1H-MRSwere performed in53cases (17cases with intracranial tuberculosis,19cases with viralencephalitis, and17cases with low-grade gliomas) before treatments or operations.The diagnosis was made clinically in cases with intracranial tuberculosis or viralencephalitis and confirmed surgically and pathologically in cases with low gradegliomas. The apparent diffusion coefficient (ADC) values, relative cerebral bloodvolumes (rCBV) values, relative cerebral blood flow (rCBF), relative mean transitiontime (rMTT), Cho/Cr and Cho/NAA of the three group were calculated and analyzed,and then statistical analyses were performed with one way ANOVA by using thesoftware of SPSS15.0.Results:（1）DWI：The rADC value of viral encephalitis was (0.481±0.244), whichwas lower than (1.365±0.081）of intracranial tuberculosis and（1.718±0.140）oflow-grade gliomas (p <0.05). The rADC value of intracranial tuberculosis was lowerthan low-grade gliomas (p <0.05).（2）PWI：The rCBV value of intracranialtuberculosis was（0.490±0.093）, which was lower than (1.999±0.786）of viralencephalitis and（1.748±0.192）of low-grade gliomas (p <0.05). There was nosignificant difference was found between viral encephalitis and low-grade gliomas.The rCBF value of viral encephalitis was（2.175±0.825）, which was higher than(0.546±0.283) of intracranial tuberculosis and（1.082±0.095）of low-grade gliomas (p<0.05). No significant difference was found in the rMTT in the three groups(p>0.05). （3）1H-MRS：There was significant difference in the ratio of Cho/Cr in the mass ofintracranial tuberculosis，viral encephalitis and low-grade gliomas[(2.012±0.166)，(1.732±0.093) and (2.275±0.133), respectively，p <0.05]. There was significantdifference in the ratio of Cho/NAA in the mass of intracranial tuberculosis，viralencephalitis and low-grade gliomas[(1.702±0.034)，(1.483±0.073) and (2.118±0.463),respectively，p <0.05]. Cho of the intracranial tuberculosis was higher than that ofnormal control tissues (rCho=1.144±0.038). In12of the19viral encephalitis, Cho ofthe viral encephalitis was lower than that of normal control tissues（rCho=0.821±0.019）. In the rset of19viral encephalitis, Cho of the viral encephalitiswas higher than that of normal control tissues（rCho=1.192±0.038）. Cho of thelow-grade gliomas was higher than that of normal control tissues (rCho=1.338±0.090).Conclusion:（1）The ADC value and rADC value of DWI play important roles in thedifferential diagnosis between intracranial tuberculosis, viral encephalitis andlow-grade gliomas.（2） The rCBV and rCBF value of PWI are helpful indifferentiating intracranial tuberculosis from viral encephalitis and low-grade gliomas.Proceeding studies are required to evaluate the value of rMTT.（3）The ratios ofCho/Cr、Cho/NAA、rCho in1H-MRS may be not value in differentiating intracranialtuberculosis from viral encephalitis. However, because of the limited sample,proceeding studies are required to validate the conclusion. |
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