Application Of Intra-voxel Incoherent Motion Imaging And Arterial Spin Labeling Technique In Preoperative Grading Of Gliomas

Objective:To investigate the value of intra-voxel incoherent motion imaging and arterial spin labeling technique in preoperative grading gliomas.Methods:Thirty-one patients with gliomas proved by pathology were enrolled,all patients did not undergo treatment before MRI examination,including 12 females and17 males,aged 26 to 74 years,with an average age of 52 years old.Twelve cases with low grade gliomas,and 19 cases with high grade gliomas.All patients underwent conventional MR imaging,3D-ASL and IVIM examination before operation.Original dates were disposed in particular software,then the images of CBF,D* and D were obtained,region of interests were selected and relevant parameter values were calculated.The parameter values were analyzed in SPSS,unpaired two-tailed Student t test were performed to compare the 3D-ASL and IVIM between two groups,P<0.05 was regarded as statistically significant.Receiver operating characteristic(ROC)analysis curves were performed to determine optimum thresholds for differentiation and also to calculate the sensibility and specificity.Finally,the sensibility and specificity of the associating screening of 3D-ASL and IVIM were obtained.Result:1.The CBF and r CBF values of high grade gliomas group(103.89±27.00 and4.28±0.63)were significantly higher than those of low grade gliomas group(63.96±22.17 and 2.72±0.84)(P<0.05).The D* and r D* values of high grade gliomas group (3.82±0.60 and 1.95±0.30)were significantly higher than those of low grade gliomas group(2.54±0.50 and 1.28±0.14)(P<0.05),while the D and r D values of high grade gliomas group(0.58±0.12 and 2.40±0.49)were significantly lower than those of low grade gliomas group(0.75±0.12 and 3.11±0.42)(P<0.05);2.Statistical analysis in ROC demonstrated AUC value of 0.879 and 0.917 for CBF and r CBF,a threshold value of 79.24 and 2.85 for CBF and r CBF of two groups to provide sensibility and specificity of 84.2%?83.3% and 100%?83.3%,and AUC value of 0.925?0.846?0.956 and 0.882 for D*?D?r D* and r D,a threshold value of 2.95?0.63?1.40 and 2.95 for D*?D?r D* and r D of two groups to provide sensibility and specificity of 94.7%?83.3% and 91.7%?73.3% and 94.7%?91.7% and 75% ?94.7%;3.The sensibility and specificity of the associating screening of 3D-ASL and IVIM were 100%?91.7%.Conclusion:1.The difference of CBF?D*?D and r CBF?r D*?r D values between low grade gliomas and high grade gliomas are statistically significant,so the parameters can be use to grade gliomas,and the values of r CBF?r D*and r D are optimal indicator;2.The sensibility and specificity of single functional imaging technique are not satisfied,associating screening of 3D-ASL and IVIM can improve the sensibility and specificity of grading gliomas.