Correlation Study Of Multimodal Magnetic Resonance Imaging With The Pathological Grade And The Expression Of Ki-67 And Survivin Of Gliomas

Part Ⅰ Clinical Evaluation of Multimodal magnetic resonance imaging in the grading of gliomasObjective:To increase the diagnostic level before operation by detecting the difference in the parameters derived from diffusion tensor imaging(DTI)and proton magnetic resonance spectroscopy(’H-MRS)between low-grade and high-grade glioma.Methods:This study included 50 patients of gliomas proved by surgery and pathology containing 22 low-grade gliomas and 28 high-grade gliomas.All the patients were examined with routine MRI,DTI and 1H-MRS.Apparent diffusion coefficient(ADC)value and fractional anisotropy(FA)value of tumor and contralateral white matter were measured respectively.The ratios of NAA/Cr,NAA/Cho and Cho/Cr were assessed from spectral maps in the solid portion of tumor and contralateral normal-appearing white matter.Analysis the differences of these parameters between high and low grade gliomas and the correlation in these parameters.SPSS 17 software was used to statistical analysis of data.P<0.05 indicated statistical significance.Results:The ADC value,FA value and ratios of NAA/Cr,NAA/Cho,Cho/Cr in gliomas had significant differences with contralateral normal-appearing white matter(P= 0.00).There was significant difference in ADC value,rADC value and ratios of NAA/Cr,NAA/Cho,Cho/Cr between high grade glioma and low-grade glioma parenchyma,but the FA and rFA value had no statistic significance(P>0.05).The rADC value and ratios of NAA/Cr,NAA/Cho and Cho/Cr significantly correlated with the histological grade of gliomas(P<0.01).Conclusion:The parameters of DTI and MRS have obvious differences in the high and low grade glioma.Combined with DTI and 1H-MRS can provide some effect of diagnosis of brain glioma.Part Ⅱ Study on the correlation between parameters of DTI and 1H-MRS and the Expression of Ki-67 and Survivin of gliomaObjective:To evaluate the possibility of using DTI and MRS in assessment of Ki-67 and survivin expression in glioma by analyzing the relationship between them.Through analysis of DTI and MRS can increase awareness of tumor proliferation activity and apoptotic status,help making clinical treatment plan and providing greater assessment of prognosis in patients.Methods:The expression of Ki-67 and survivin in glioma were tested by immunohistochemistry.The corelation between parameters of DTI and 1H-MRS and the expression of Ki-67 and survivin in different grade gliomas are studied in statistical method.SPSS 17 software was used to statistical analysis of data.P<0.05 indicated statistical significance.Results:The Ki-67 antigen expression index(EI)and survivin Immunoreactivity score(IRS)of high grade glioma are higher than low grade glioma.Except for FA and rFA value,there are some correlation between the parameters of DTI and ’H-MRS and the expression of Ki-67 and survivin in glioma.Conclusion:Ki-67 antigen expression index and survivin immune response score have obvious differences in the high and low grade glioma,Ki-67 antigen expression index and survivin immune response score can better evaluate tumor proliferation activity and malignant degree.The ADC,rADC value and parameters of MRS were closely correlated with Ki-67 antigen expression index and survivin immune response.All of these indicate that the parameters of DTI and 1H-MRS can be used to evaluate the molecular biology behavior of glioma.