DTI And MRS Study Of Preoperative Glioma Grading

Objective: To study the value of FA and ADC valve, the ratio of Cho/Cr, NAA/Cr, Cho/NAA in evaluating glioma grading and distinguish glioma tumors between and peritumoral edema.Methods: this study selected 35 patients with glioma from **** hospital of *****from March,2013 to february,2014.In the 2007 WHO international standards glioma are divided into Ⅰ ~ Ⅳ level, including 21 cases ofⅠ ~ Ⅱ level, as low grade glioma(LGG), 14 cases of Ⅲ ~ Ⅳ level, for the high grade glioma(HGG).All the two groups are received routine MRI scan and enhanced scan, the DTI scan, MRS scans. DTI data reprocessing, measured lateral tumors in patients with disease, peritumoral edema area and the contralateral corresponding area of the FA and ADC values. Analyze the differences between low-level and high-level group of tumor area group tumor area FA values and ADC values group, FA values in the low-level analysis and high-level group group group tumor area and contralateral normal area of the mirror and ADC value differences and analysis of the low-level and high-level group group group differences in FA and ADC values of the tumor area and peritumoral edema region. MRS application software calculates the machine itself is a region of interest(tumor area, peritumoral edema, corresponding contralateral region) of Cho / Cr, NAA / Cr, Cho / NAA ratio analysis of low-level and high-level group of tumor area group tumor area Cho / Cr, the difference between the NAA / Cr, Cho / NAA ratio group, the low-level analysis Cho group and high-level group set mirrored contralateral tumor area and normal area / Cr, NAA / Cr, Cho / NAA ratio differences, as well as the low level group Cho analysis and high-level group set tumor area and peritumoral edema region / Cr, NAA / Cr, Cho / NAA ratio differences. Correlation analysis of glioma Cho / Cr ratio and ADC values.Results:1, low grade glioma with high grade glioma had the FA and ADC, Cho/Cr, NAA/Cr, Cho/NAA ratio has significant statistical difference(t = 3.529, P < 0.05, t = 0.05, P < 0.05, t =-- 6.185, P < 0.05, t = 0.05, P < 0.05, t =-- 6.572, P < 0.05). 2, low grade glioma and the contralateral normal zone, the high grade glioma and the FA of the contralateral normal area, ADC, Cho/Cr, NAA/Cr, Cho/NAA ratio has significant statistical difference(t =-- 6.109, P < 0.05, t = 0.05, P < 0.05, t = 0.05, P < 0.05, t =--12.116, P < 0.05, t = 0.05, P < 0.05, t =-- 9.053, P < 0.05, t = 0.05, P < 0.05, t = 0.05, P < 0.05, t =-- 18.887, P < 0.05, t = 0.05, P < 0.05). 3, The FA, ADC value and Cho/Cr, NAA/Cr, Cho/NAA ratio of low grade glioma and the peritumoral edema are significant statistical difference(t = 8.073, P < 0.05, t =-- 8.328, P < 0.05, t = 0.05, P < 0.05, t =-- 5.803, P < 0.05, t = 0.05, P < 0.05); The ADC value, Cho/Cr, NAA/Cr, Cho/NAA ratio Week of high group glioma and the peritumoral edema are significant statistical difference(t =-- 3.238, P < 0.05, t = 0.05, P < 0.05, t =-- 3.678, P < 0.05, t = 0.05, P < 0.05); The FA value of High group glioma and the peritumoral edema have no statistical difference(t =-- 2.519, P > 0.05). 4. Cho / Cr ratio was negatively correlated with the ADC value in glioma, r =-0.605, P <0.05.Conclusion:1, DTI is a study of the structure of the brain from the microscopic point of view, functional changes noninvasive imaging technique that can be objectively and accurately display the structure of the fiber bundle brain regions, through the ADC value, FA quantitative value analysis, high accuracy, has important implications for the assessment of patients with different levels of glioma. ADC value can be used todistinguish between low-grade gliomas and high-grade glioma tumor area and peritumoral edema. FA values can only distinguish between low-grade glioma tumor area and peritumoral edema. 2, MRS is able to detect a non-invasive in vivo imaging of brain tissue metabolism, brain tissue can provide metabolite, changes in the concentration of the compound of accurate, by Cho / Cr, NAA / Cr, Cho / NAA ratio quantification analysis, can be more accurate assessment of glioma grade, distinguish tumor parenchyma and peritumoral edema. 3, Cho / Cr ratios were significantly associated with the ADC value in glioma, so the combination of DTI and MRS helps assess grade gliomas, and to more accurately delineate the scope of tumor parenchyma.