| Objective: The T1 and T2 values were measured quantitatively by magnetic resonance imaging compilation(Magic).We aimed to investigate the clinical values of T1、T2 value pre-and post-contrast and T1 value post-contrast in predicting glioma grading and tumor proliferation.Materials and Methods: A retrospective study of 36 patients with histopathologically proven brain glioma was performed,including 21 cases of high grade glioma(HGG)and15 cases low grade glioma(LGG).All patients received Magic sequence scan and Magic contrast-enhancement scan simultaneously 1 week before surgery.The T1 and T2 values were automatically generated from T1 WI and T2 WI before(T1-pre,T2-pre)and after(T1-Gd)the contrast enhancement on the areas of tumor solid parts and normal white matter(NAWM)of the contralateral mirror,and the average values were calculated.The ratio of T1-pre(r T1-pre),the ratio of T2-pre(r T2-pre),the ratio of T1-Gd(r T1-Gd),the different of T1 values before and after contrast enhancement [ΔT1=(T1-pre)-(T1-Gd)]and the percentage change of T1 values were calculated.The parenchyma of glioma specimens were taken for HE staining and Ki-67 immunohistochemical staining after surgery,so as to determine the pathological grading of gliomas and Ki-67 labeling index(Ki-67 LI).The differences of Magic measured values and Ki-67 LI between high and low grade glioma groups were analyzed,and receiver operating characteristic(ROC)analysis was performed for the quantitative values with statistically significant differences.The differences of Magic measured values and Ki-67 LI between Ⅱ and Ⅲ,Ⅱ and Ⅳ,Ⅲ and Ⅳ were analyzed.The correlation between the quantitive values and Ki-67 LI was analyzed.Results: The T1-pre,ΔT1,the percentage change of T1 values,Ki-67 LI were significantly higher in the HGG compared to the LGG(P<0.05),whereas T1-Gd、r T1-Gd were significantly lower in HGG than LGG(P<0.05).There was no significant difference for r T1-pre,T2-pre and r T2-pre between high and low grade gliomas(P>0.05).The ROC curve was performed,when the T1-pre≥1421.5ms,ΔT1≥373.25 ms,the percentage change of T1 values≥51.47% and Ki-67 LI≥9,the sensitivity of diagnosis of high grade gliomas respectively were 57.1%,90.58%,71.4%,100%,the specificity of diagnosis of high grades glioma respectively were 86.7%,60%,80%,73.3%,the area under the curve respectively were 0.759,0.816,0.790,0.925;when the T1-Gd<748.71 ms,r T1-Gd<1.13,the sensitivity of diagnosis of high grade gliomas respectively were 85.7%,81%,the specificity of diagnosis of high grade gliomas respectively were66.7%,66.7%,the area under the curve respectively were 0.752,0.746.ΔT1 compared with the other measured values have the best diagnosis efficiency in distinguishing HGG from LGG.T1-pre,T1-Gd,r T1-Gd,ΔT1,the percentage change of T1 values and Ki-67 LI had significant differences between Ⅱ and Ⅲ,Ⅱ and Ⅳ(P<0.05).The values of r T1-pre,T2-pre,r T2-pre had no significant differences between Ⅱ and Ⅲ,Ⅱ and Ⅳ(P>0.05).T1-pre,r T1-pre,T2-pre,r T2-pre,T1-Gd,r T1-Gd,ΔT1,the percentage change of T1 values and Ki-67 LI has no significant differences between Ⅲ and Ⅳ(P>0.05).T1-pre(r=0.502,P=0.002),r T1-pre(r=0.331,P=0.048),ΔT1(r=0.537,P=0.001),the percentage change of T1 values(r=0.473,P=0.004)were significant positive correlated with Ki-67 LI.T1-Gd was significant negative correlated with Ki-67 LI(r=-0.351,P=0.036).There was no correlation between T2-pre,r T2-pre,r T1-Gd and Ki-67 LI,and the difference was no statistically significant(P>0.05).Conclusion: Quantitive T1 value was valuable in differentiating HGG rom LGG and predicting tumor proliferation,which was contributed to make appropriate management strategies and prognostic assessment. |
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