The Value Of ~1H-MRS In The Diagnosis And Grading Of Brain Gliomas

PurposeTo investigate the value of proton magnetic resonance spectroscopy(~1H-MRS)in preoperative diagnosis and grading of brain gliomas.MethodForty-two gliomas confirmed by surgery and pathology in our hospital from March 2016 to December 2017 were divided into low-grade group(grades I-II)and high-grade Patients in group(III-IV)underwent 3.0TMRI routine scan and enhanced scan and ~1H-MRS(~1H-MRS)before operation.The ~1H-MRS spectra were processed at the workstation to measure the area under the peak of each metabolite in each region of interest,and the average values of NAA/Cr,Cho/Cr and NAA/Cho ratios were calculated.All data were analyzed by SPSS 17.0software.The measurement data were expressed as mean±standard deviation(X±S),and then homogeneity of variance was tested firstly.The statistical methods included independent sample t test,paired t test and chi square test Test,the correlation analysis of each index using Spearman test,P<0.05 that the difference was statistically significant.Results1?~1H-MRS of gliomas mainly showed the NAA peak decreased significantly,Cr peak changed little,Cho peak was significantly increased;and~1H-MRS image glioma tumor area ratio of metabolites NAA/Cr,Cho/Cr,NAA/Cho and contralateral normal brain tissue were significantly different(P<0.05).2?The ratios of NAA/Cr,Cho/Cr and NAA/Cho of metabolites in high grade and low grade gliomas were significantly different(P<0.05).The ratio of Cho/Cr in glioma was positively correlated with tumor pathological grade.The ratio of NAA/Cr and NAA/Cho was negatively correlated with tumor pathological grade.The Lac peak appeared in both high grade gliomas and low grade gliomas,with no significant difference(P>0.05).Lip peak was only found in high grade gliomas(P<0.05).3?The difference of Cho/Cr,NAA/Cho ratio between the low-grade glioma and the contralateral normal tissue was statistically significant(P<0.05),while the NAA/Cr ratio had no statistical significance(P>0.05).There were significant differences in NAA/Cr,Cho/Cr,NAA/Cho ratios between the high-grade glioma and the contralateral normal tissue(P<0.05).The difference of NAA/Cr,Cho/Cr and NAA/Cho in high and low grade gliomas was statistically significant(P<0.05).Conclusions1?~1H-MRS is an effective complement to conventional MRI in the diagnosis of glioma,which can provide biochemical metabolic information of tissue cells at the micro-molecular level.2?The ratio of ~1H-MRS metabolites in glioma region can effectively reflect the pathological grade of tumor.With the increase of Cho/Cr ratio,the ratio of NAA/Cr and NAA/Cho decreased,and the pathological grade of tumor increased.3?In addition to the tumor area,changes in the ratio of ~1H-MRS metabolites in the peripanal edema area of the glioma tumor also have some value in the classification of the glioma,which can reflect the aggressiveness of the tumor.