The Application Of DCE-MRI And 3D-ASL In Preoperative Grading Diagnosis Of Diffuse Glioma

Objective:To evaluate the diagnostic efficacy of three-dimensional arterial spin labeling(ASL)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the preoperative grading of diffuse glioma,and to analyze the correlation between the two perfusion methods in the grading of glioma.Methods:Fifty-seven cases of pathologically confirmed diffuse glioma(38 HGG and 19 LGG)were collected,and all patients underwent routine cranial MRI plain scan,enhancement,ASL and DCE-MRI.Functool and GENIQ software of GE ADW4.6 post-processing workstation were used for post-processing of ASL and DCE-MRI data,respectively.Quantitative parameters related to ASL were obtained:tumor CBF and normal brain tissue CBF of the mirror image side,and the ratio of CBF to the mirror image side(rCBF)were obtained.(2)DCE-MRI related quantitative parameters:tumor volume transport constant(Ktrans),extravascular extracellular space volume ratio(Ve),plasma volume fraction(fpv)and the above parameters of normal brain tissue on the mirror side,and the ratio of each parameter to the mirror side(rKtrans,rVe,rfpv);At the same time,Ktrans,Ve,fpv and rKtrans,rVe and rfpv were obtained within 1cm of the tumor week and at 1-2cm of the tumor week.The differences in age,gender,tumor rCBF,tumor and perioma DCE parameters(Ktrans,Ve,fpv,rKtrans,rVe,rfpv)of patients with high and low grade diffuse glioma were compared,and the diagnostic efficacy of the parameters with statistical differences was obtained by ROC curve.Finally,the correlation between rfpv and rCBF-ASL of high grade and low grade glioma was analyzed.Results:The age of HGG patients was significantly higher than that of LGG patients(t=3.719,P<0.001).The rCBF-ASL,Ktrans,Ve,fpv,rKtrans,rVe,and rfpv values in the HGG tumor were all greater than LGG,and the differences were statistically significant,P<0.05(Z values were-2.209,-4.580,-4.176,-3.453,-4.359,-3.631,-3.665,respectively).However,there were no statistically significant differences in the values of Ktrans,fpv,rKtrans,rVe and rfpv between the two groups of HGG and LGG in gender,within 1cm of tumor week and at 1-2cm of tumor week.ROC curve analysis showed that the areas under the curves of rCBF and rKtrans were 0.681 and 0.857,respectively.The area under the curve for the combined application of rKtrans and rfpv was 0.865.Correlation analysis showed that there was no correlation between rfpv and rCBF-ASL.Conclusion:The quantitative parameters of rCBF,Ktrans,Ve,fpv,rKtrans,rVe and rfpv measured in the tumor obtained based on 3D-ASLand DCE-MRI can be used to distinguish high grade gliomas from low grade diffuse gliomas before surgery.rKtrans has the highest diagnostic efficiency,and the combined application of rKtrans and rfpv can further improve the diagnostic efficiency.