Application Of Conventional MRI Imaging Features Combined With 1H-MRS In Grading Diagnosis And Prediction Of Postoperative Recurrence Of Glioma

Objective:To explore the imaging characteristics of conventional MRI and the value of 1H-MRS in preoperative grading diagnosis and prediction of postoperative recurrence of gliomas in patients with gliomas through preoperative conventional MRI and 1H-MRS scans.Methods:1.From January 2020 to December 2021,a total of 68 patients with brain glioma who were clinically diagnosed in the First Affiliated Hospital of Bengbu Medical College were selected.Before surgery,they all underwent MRI plain scan,enhanced scan and 1H-MRS examination.3D Slicer software was used to post process the MRI plain scan and enhanced images to obtain the volume of tumor parenchyma,the surface area of tumor parenchyma,the volume of peritumoral edema The surface area of peritumoral edema and the ratio of the volume of peritumoral edema to the volume of tumor parenchyma,etc.At the same time,the post-processing analysis software attached to the magnetic resonance machine was used to post-process the 1H-MRS image.The region of interest(ROI)was selected on the spectrogram,and the ROI was placed in the solid part of the tumor and the peritumoral edema area.The concentrations of N-acetylaspartate(NAA),choline(Cho)and creatine(Cr)were determined,and the relative ratios of Cho/Cr and Cho/NAA were calculated.SPSS 26 software was used to statistically analyze the data and compare the differences of the above quantitative indicators of different grades of brain glioma.2.All patients with brain glioma received standardized surgical treatment.They were followed up in the outpatient department for 12-24 months after surgery.They were divided into recurrent group and non recurrent group according to the diagnosis confirmed by reoperation histopathology or follow-up.The volume of tumor parenchyma,the volume of peritumoral edema,the ratio of peritumoral edema to tumor parenchyma,and the ratios of Cho/NAA and Cho/Cr in tumor parenchyma were compared between patients with and without recurrence.ROC curve was used to evaluate the efficacy of the above indicators in predicting postoperative recurrence of glioma.Results:1.The imaging characteristics of conventional MRI showed that the volume and surface area of tumor parenchyma,the volume and surface area of peritumoral edema,and the ratio of peritumoral edema volume to tumor parenchyma volume were significantly different between HGG group and LGG group(P<0.05).1H-MRS images showed that the ratios of Cho/NAA and Cho/Cr between the tumor parenchyma area and peritumoral edema area were significantly different between HGG group and LGG group(P<0.05).The above quantitative indexes in HGG group were higher than those in LGG group.2.The follow-up results of patients after operation showed that the volume of tumor parenchymal area,the volume of peritumoral edema,the ratio of peritumoral edema volume to tumor parenchymal area volume,and the Cho/NAA and Cho/Cr values of tumor parenchymal area in the relapsed group were higher than those in the non relapsed group before operation,and the difference was statistically significant(P<0.05).The ROC curve results showed that the above indicators were of high value in predicting the recurrence of glioma after operation(AUC>0.7).Conclusions:1.Conventional MRI features and 1H-MRS imaging of tumor parenchyma and peritumoral edema can effectively improve the accuracy of preoperative grading diagnosis of glioma.2.The volume of tumor parenchyma area before operation,the volume of peritumoral edema,the ratio of peritumoral edema volume to the volume of tumor parenchyma area,and the Cho/NAA and Cho/Cr values of tumor parenchyma area have certain value in the diagnosis of recurrence of glioma after operation.The most sensitive indicator is the volume of tumor parenchyma area,and the most specific indicators are Cho/NAA and Cho/Cr.3.The imaging features of conventional MRI combined with 1H-MRS have a better diagnostic value in predicting the recurrence of glioma after surgery than other independent indicators.