Application of MRS and ASL in the diagnosis of pseudoprogression in high-grade glioma

WANG Jihua; ZHANG Zaiyun; LI Xiaomei; CHENG Jian; JIANG Yuhua

Abstract：Objective To investigate magnetic resonance spectroscopy ( MRS) and arterial spin labeling ( ASL) in the diag-nosis of pseudoprogression in high-grade glioma.Methods 36 high-grade glioma patients who had presented with enlarged con-trast-enhanced lesions on magnetic resonance imaging ( MRI) one month after completing concurrent chemoradiotherapy were en-rolled in the second hospital of shandong university from Jan 2013 to Dec 2015.Metabolites and their ratio were analyzed with MRS, blood flow was measured with ASL, both of MRS and ASL were applied to determine whether there was pseudoprogression or tumor recurrence in the lesion area.Results In 36 cases, 28 cases were confirmed as pseudoprogression, 8 cases as recur-rence, by re-surgery or with follow-up for 10 months.Pseudoprogression diagnosed by MRS, ASL and combination were 19 cases, 23 cases and 26 cases respectively.Decreased Cho/Cr and NAA/Cr were shown in MRS and low perfusion in ASL in the patients with pseudoprogression.Increased Cho/Cr and decreased NAA/Cr were shown in MRS and high perfusion in ASL in the patients with tumor recurrence.Conclusion Combination of MRS and ASL analysis can be used in diagnosis of pseudoprogression of glio-ma,which has good clinical application prospect.