The Values Of DWI And ~1H-MRS In The Differential Diagnosis Between High-grade Gliomas And Solitary Metastases

Objective To investigate the differential diagnosis values of apparent diffusion coefficient、exponent diffusion coefficient and Cho/Cr、Cho/ NAA、NAA/Cr in high-grade gliomas and single metastases.Methods To collect the complete MRI data of 50 cases high-grade gliomas and 20 cases solitary metastases pathologically confirmed after surgery in our hospital,including conventional MRI scan、enhanced scan、DWI and 1H-MRS.Retrospectively analyzed the imaging features of all lesions and then send the original images of 1H-MRS and DWI to post-processing workstation ADW4.4, using Functool-2 to draw ADC and EADC map, then measuring the ADC values、EADC values and the ratio of Cho/Cr、Cho/NAA and NAA/Cr in each region of interest such as tumor parenchyma、peritumoral edema and contralateral normal white matter. Evaluating the significance of each parameter value in differential diagnosis of the two tumors.Results ①Both of the average ADC values of high-grade glioma in tumor parenchyma and peritumoral area were higher than the relatively normal area, and pairwise comparisons were significantly different; Both of the average EADC values of the two areas were lower than the relatively normal area, and pairwise comparisons were significantly different; Both the ratio of Cho/NAA and Cho/Cr in the two areas were significantly higher than the relatively normal area, and pairwise comparisons were significantly different;the the ratio of NAA/Cr in the two areas were lower than the relatively normal area, and pairwise comparisons were significantly different.②Both of the average ADC values of solitary metastases in tumor parenchyma and peritumoral area were higher than the relatively normal area, there was a significant difference between the two by two; both of the average EADC values of the two areas were lower than the relatively normal area, and there was a significant difference between the two by two; the ratio of Cho/NAA and Cho/Cr in tumor parenchyma area were relatively higher than the normal area, and there was a significant difference between them; the ratio of NAA/Cr in tumor parenchyma area was lower than relatively normal area, and there was a significant difference between them; the ratio of Cho/NAA、Cho/Cr and NAA/Cr in peritumoral area were similar to the normal, there was no significant difference between them.③The ADC values、EADC values and the ratio of NAA/Cr in parenchyma areas of high-grade gliomas and metastases had no significant difference,but the ratio of Cho/NAA and Cho/Cr in the tumor areas had a significant difference,and the ADC values EADC values and the ratio of Cho/NAA、Cho/Cr、NAA/Cr in peritumoral areas had a significant difference.Conclusion DWI and 1H-MRS can provide differential diagnosis for high-grade gliomas and solitary metastases, and to be combined with conventional MRI examination is beneficial for the diagnosis of the two tumors.