Combined application of magnetic resonance DTI and multi-voxel 1H-MRS in preoperative classification of glioma

JIN Qin; XU Min; SUN Huihui; ZHANG Xuefeng

Abstract：Objective To explore the clinical combined application value of MR diffusion tensor imaging (DTI) and multi-voxel proton MR spectroscopy (1 H-MRS) in preoperative classification diagnosis of glioma.Methods We retrospectively ana-lysed regular MR,DTI and 1H-MRS images of 38 patients with pathology confirmed glioma from the our hospital,which included 15 cases of low grade glioma(LGG,WHO II) and 23 cases of high grade glioma(HGG,WHO III~IV). We reconstructed the diffusion tensor tractography(DTT) images based on the seed points of brain tissue around the tumor,measured fractional anisot-ropy(FA),mean diffusion coefficient(MD),choline(Cho)/creatine(Cr),Cho/N-acetylaspartate(NAA),NAA/Cr values of tumor tissue(TT),brain tissue around tumor(AT) and contralateral normal brain tissue(CT),and compared the differences of each parameter among different tissues in group, and the differences of each parameter between groups. Results DTT images showed white matter fiber tracts of TT and AT were disrupted (19/23, 82.6%) mostly in HGG, invaded (13/15, 86.7%) mostly in LGG. In HGG group,the FA,MD and NAA/Cr were gradually increased, Cho/Cr and Cho/NAA were gradually de-creased from TT,AT to CT ( P <0.05). In LGG group,the FA,MD and NAA/Cr of TT were lower than that of AT and CT, the Cho/Cr and Cho/NAA were opposite ( P <0.05). The MD and NAA/Cr of HGG were lower,the Cho/Cr and Cho/NAA of HGG were higher than that of LGG on TT and AT( P < 0. 0 5). The FA of HGG was lower than that of LGG only at AT area ( P <0.05). Conclusion Clinic can combinedly apply the parameters of DTI and multi-voxel 1H-MRS to do preoperative clas-sification diagnosis of glioma,which could be benefit for timely selecting more reasonable individualized treatment project.