Grading of diffuse astrocytomas with in vivo ~1H MR spectroscopy,perfusion and diffusion imaging / 中华放射学杂志

ABSTRACT

Objective To discuss the value of vivo proton MR spectroscopy,perfusion and diffusion imaging in grading of diffuse astrocytomas.Methods One hundred fifty-four cases with diffuse astrocytomas proved pathologically were collected.35 cases with diffuse astrocytomas including 8 astrocytomas(WHO grade Ⅱ),13 anaplastic astroeytomas(grade Ⅲ)and 14 glioblastoma muhiforms (grade Ⅳ)underwent MR spectroscopy.The Cho/Cr,NAA/Cr and Lac/Cr of three groups in 35 cases were compared.The other 76 cases including 36 low-grade glial tumors(grade Ⅱ),20 anaplastic glial tumors (grade Ⅲ)and 20 glioblastoma multiforms(grade Ⅳ)underwent conventional MR imaging and dynamic contrast-enhanced perfusion MR imaging before surgical resection or stereotactic biopsy,the characteristics of the curve and the value of the maximum relative regional cerebral volume(rrCBV)in the diffuse astrocytomas with various grades were analysed.Fourty-three cases of diffuse astrocytomas including 26 astrocytomas(grade Ⅱ),6 anaplastic astrocytomas(grade Ⅲ)and 11 glioblastoma multiformes (grade Ⅳ)underwent diffusion MRI and the apparent diffusion coefficient rate(ADCR)were compared. Results The Cho/Cr of diffuse astrocytomas in three grades were 2.709?1.228,5.812?2.374 and 5.289?1.462 respectively.There were statistically significant differences between astrocytomas and anaplastic astrocytomas,astrocytomas and glioblastoma multiformes for Cho/Cr(P0.05).The Lac/Cr of diffuse astrocytomas in three groups were 0.100?0.083,1.879?1.595 and 3.656? 2.195 respectively,the differences among three groups were all significant(P0.05).The maximum rrCBV values of glial tumors with Ⅱ,Ⅲ and Ⅳ grade were 1.379?0.739,2.654?1.072,3.218?1.565 respectively and the differences among them were statistically significant(P