| Glioma is a derived neuroepithelial cells, the most common primary brain tumor.Because with the pathological level, the greater the degree of malignancy, peripheraledema and cystic necrosis and tumor border indistinguishable complete resectionsurgery more difficult, the higher the mortality. Surgical biopsy is still considered themost important method to determine the tumor type and value-added activity, but therisk of complications and by the limitations of invasive seek a noninvasive MRI Minew technologies to understand glioma cell proliferation activity glioma patients has avery important significance. Select glioma treatment program has been a matter ofclinical concern, and the means to affect the application of science can provide manyvaluable clinical information in the preoperative grading, to help make better clinicaltreatment programs in glioma selection.Glioma conventional MRI, can be a good judge tumor location, size observedimage to form tumors, peritumoral edema, mass effect, strengthening the relationshipbetween fashion and the adjacent tissue. With the continuous development of medicalimaging techniques, functional magnetic resonance imaging (functional magneticresonance imaging, fMRI) to be applied more widely to the research and clinicaldiagnostic medicine. These imaging techniques can not only display the shape of thelesion, but also provides information on tumor metabolism function, hemodynamicsand functional areas of the cortex, providing more reliable and complete informationfor clinical. Which diffusion weighted imaging (diffusion weighted imaging, DWI) toobserve the microscopic diffusion motion of water molecules in living tissue, DWIdoes not require reference to the contrast agent into the body, the direct use of watermolecules in the brain can be imaged by measuring the tumor tissue The apparentdiffusion coefficient (apparent diffusion coeffcient, ADC) values can reveal tumorsconfiguration information from the microscopic level.Biological behavior of malignant glioma its most fundamental reason is the continuous proliferation of tumor cells, Ki-67is a specific expression of proliferatingcell nuclear antigen gene is located on chromosome10in the cell cycle G1, S, G2,nuclear expression M phase, it can objectively reflect the expression of tumorproliferation activity, which is now more positive appreciation of the nuclear markergenes. Ki-67labeling index can accurately reflect the degree of malignancy ofgliomas and patient prognosis.Objective:To analyze the differences in apparent diffusion-weighted imaging lesiondetection glioma diffusion coefficient ADC values to explore three different b values(b=1000s/mm2, b=2000s/mm2and b=3000s/mm2) MRI diffusion-weightedimaging (Diffusion weighted imaging, DWI) effect on glioma imaging, quantitativeassessment of three kinds of b-value DWI in glioma grading.Routine measurement oftumor size, determine the distribution, a substantial part of the smallest accuratemeasurement of tumor ADC value and relevance of Ki-67labeling index, based onpathologic examination determined by immunohistochemistry, feedback inquiryreflect the tumor cell proliferation of Ki-67labeling index, explore the different levelsof Ki-67in glioma the expression of both research applications in preoperativegrading of gliomas in the brain, providing a reliable basis for clinical work, the bestsolution to help seek surgery to reduce recurrence.Materials and Methods:This study retrospectively studied34patients with glioma collection, its3.0TMRIplain and3different b values of diffusion-weighted imaging, routine measurement oftumor size to determine the distribution of accurate measurements tumor parenchyma,regional and relatively normal peritumoral edema surrounding area ADC values andsignal values, evaluate the measurement corresponding contralateral normal whitematter ADC values, measured values of the background noise signal, the ADC valuesof each region of interest, the signal value of the signal to noise relationship ratio,contrast and b values comparing the standard deviation, the original data to theworkstation processing Functcol GE software. Statistical analysis, using SPSS17.0 statistical software measurement data as mean±standard deviation.Results:The mean ADC value of each region of interest is reduced. When the value of bfrom1000s/mm2to2000s/mm2, tumor, peritumoral, contralateral normal mean ADCvalue area decreased by approximately53.6%,29.8%,33.7%, when the b value from2000s/mm2to3000s/mm2tumor body, peritumoral, contralateral normal areaADCvalue decreased approximately62.9%,55.7%,48.2%. In the b value1000s/mm2,2000s/mm2and3000s/mm2difference between any two statistically significant (p<0.05).Substantial part of high-grade glioma tumors, peritumoral region ADC valuesbelow the low-grade glioma tumor substantial part of ADC values between the twothere are statistically significant differences (P <0.01). Substantial part of gliomatumor, peritumoral region malignant tumor ADC value was significantly negativelycorrelated.With the b value increased, DWI minimum ADC value of tumor contrast, theresults of the three groups, the mean minimum ADC value LGG were higher than theaverage of the minimum ADC value HGG (P <0.001).The minimum ADC value, Ki-67labeling index and tumor grade correlation b=1000s/mm2, b=2000s/mm2, b=3000s/mm2DWI substantial part of the tumor andthe level of the minimum ADC value was significantly negatively correlated. HGGlevel of Ki-67expression is higher than the LGG group, LGG ((3.3±2.4)%), HGG((14.8±7.3)%), the difference was statistically significant ((P <0.01). Ki-67degreeexpression was positively correlated with the degree of glioma malignancy.Conclusion:With the increasing value of b, the image signal to noise ratio decreased, theimage signal values decrease in the degree of peritumoral region relative maximum,while ADC values in the tumor area to reduce the most obvious. Substantial part ofthe tumor ADC values close to or even lower than normal brain parenchyma,suggesting that high-grade gliomas, whereas low-grade gliomas may be prompted. High b-value (b=3000s/mm2) tumors and tumor contrast peritumoral region’s largest,most clearly reflects the configuration information of the tumor. Increased Ki-67labeling index was considered active on cell proliferation, which is reflected in themaximum density area of tumor cells, the results of the study, the minimum area isthe ADC value represents the maximum cell density in the region, but also the tumorthe most active area of cell proliferation, which is the highest degree of malignancy ofthe region. Therefore, the minimum measurement biopsy before surgery to helpaccurately locate high ADC values of malignant tumor area, to determine the level oftumor as accurately as possible. |
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