Multi-voxel proton magnetic resonance spectroscopy combined with ADC in differential diagnosis of glioma recurrence and radionecrosis

LU Yuhua; ZHAO Huali; ZHANG Shiyu; SHEN Qing; LIANG Zonghui

Abstract：Objective To explore the clinical application value of multi-voxel proton magnetic resonance spectroscopy (1 H-MRS) combined with ADC in differential diagnosis of glioma recurrence and radionecrosis. Methods We retrospectively ana-lysed 1H-MRS and ADC images of 38 patients after glioma surgery and radiotherapy with abnormal intensive signal on MR images from the our hospital. We measured choline(Cho)/creatine(Cr),Cho/N-acetylaspartate(NAA),NAA/Cr and ADC values of abnormal intensive signal area,edema and normal brain tissue and compared the differences of Cho/Cr,Cho/NAA,NAA/Cr and lesions-contra relative ADC (rADC) values between glioma recurrence and radionecrosis groups. ROC curve analysed the best di-agnostic boundary values of each parameter and the corresponding diagnostic sensitivity and specificity. Results All 17 patients were glioma recurrence and the rest of 21 cases were radionecrosis. The Cho/Cr,Cho/NAA of abnormal intensive signal area and edema in recurrence group were significantly higher than that in radionecrosis group ( P <0.05). The rADC of abnormal inten-sive signal area in recurrence group was lower than those in radionecrosis group( P <0.05). The best diagnosis cut off values of Cho/Cr and Cho/NAA and rADC in abnormal intensive signal area were 2.470,2.825 and 0.538. The best diagnosis cut off val-ues of Cho/Cr and Cho/NAA in edema were 1.345 and 1.750. Conclusion Clinic can jointly apply the multi-voxel 1H-MRS and ADC iamges to differentially diagnose glioma recurrence and radionecrosis, which could be benefit for timely selecting more reasonable individualized treatment project.