Study On Radiation-induced Brain Injury In Postoperative Glioma Patients Using Advanced Functional MRI Techniques

Objective Comparative study of different MR perfusion imaging method(3DASL, DSC)for the differential diagnosis of glioma recurrence and radiation injury was performed.Materials and methods Selected25cases of cerebral gliomas postoperative radiotherapyand new strengthen stove patients. All patients were confirmed by the secondary surgicalpathology or follow-up (follow-up>6months) confirmed as the radioactive brain damageor glioma recurrence.25patients underwent conventional MR scan, enhanced scan andMR perfusion imaging (DSC and3D ASL).DSC gradient echo-echo planar imaging(GRE-EPI) sequence,3D ASL FSE sequence; ROI placed in cross-sectional T1WIabnormal enhancement area, edema, surrounded by relatively normal white matter regionsand the contralateral corresponding relativenormal white matter, size20to40mm2, DSCcalculate abnormal enhancement area, relatively normal white matter edema and thesurrounding area and the contralateral normal parameter ratio, relative cerebral bloodvolume (rCBV), relative cerebral blood flow(rCBF), relative mean transit time (rMTT)peak time (rTTP),3D ASL abnormal enhancement area, edema and surrounding relativelynormal white matter CBF values; using packet t-test were compared DSC and3DASL thegluestromal tumor recurrence and radiation-induced brain injury group perfusionparameters, and DSC and3DASL diagnostic performance.Results Group of glioma recurrence abnormal enhancement of the lesion CBF values (56.15±38.403) was significantly higher than that of radiation-induced brain injury group(27.48±17.56)(P <0.001). The of glioma recurrence group edema regional CBF values (20.22±13.49) was slightly higher than the radiation-induced brain injury group (19.67±12.18), and no significant statistical difference between the two. Group of glioma recurrence strengthen lesions rCBV ratio of rCBF ratio (2.90±2.16,2.76±2.22) weresignificantly higher than the radiation-induced brain injury group (1.38±1.03,1.34±1.14)(P <0.001); glioma The rCBV ratio rCBF ratio of the recurrence group edema (1.42±0.62,1.23±0.62) was significantly higher than the radiation-induced brain injury group (0.59±0.42,0.58±0.42)(P <0.001). For3DASL and DSC correlation analysis results obtainedcorrelation coefficient between the CBF values a nd the ratio of rCBV and rCBF ratios0.518,0.597; correlation between CBF values a nd rCBV ratio and CBF values a nd rCBFratio.Conclusion3DASL can differentiation of glioma recurrence and radiation injury, with avery high specificity. CBF values and DSC perfusion scan rCBV and rCBF ratios have agood correlation, with DSC perfusion joint used to identify gliomarecurrence andradiation injury. Objective To evaluate the b-value diffusion-weighted imaging for differential diagnosis ofglioma recurrence and radiation injury.Materials and methods25cases of cerebral patients with glioma postoperativeradiotherapy and the emergence of new strengthening stove. All patients were confirmedby the secondary surgical pathology or follow-up (follow-up>6months) confirmed as theradioactive brain damage or glioma recurrence.25patients underwent conventional MRscan, the DWI and multi-b the value dispersion weighted imaging (eDWI) and3DFSPGR,conventional contrast enhanced scan sequence. Select ROI placed in the cross-sectionalT1WI abnormal enhancement area, edema and the contralateral corresponding to therelative normal white matter, size20~40mm2, eDWI measure abnormal enhancement,edema and contralateral normal white matter regions. parameter values, IVIM modelprocessing by double exponential and tensile index results.(Slow adc/fast adc/fractionof fast adc). DWI calculate abnormal enhancement, edema and contralateral white matterregions of relatively normal ADC value; grouping t test, rank sum test and analysis ofvariance methods were compared eDWI and DWI parameters for glioma recurrence andradiation injury the differential performance between the parameters.Results Glioma recurrence group enhanced lesions and edema lesions STD ADC value,Slow adc mono value, the fraction of fast adc mono value, DDC values a re slightly lowerthan the radiation-induced brain injury group STD adc value, Slow adc mono value,fraction of fast ADC mono value. Group of glioma recurrence strengthen lesions and edema area fast ADC bi value, fraction of fast adc bi value, fast ADC mono value higherthan the radiation-induced brain injury group. Glioma recurrence group enhanced lesionsAlpha value and radiation-induced brain injury group, roughly the same, and gliomarecurrence group edema area Alpha value is significantly lower than the radiation-inducedbrain injury group (P <0.05), roughly the same.Conclusion b value diffusion-weighted while providing perfusion and diffusion of thelesions, to fast the adc mono and slow ADC Mono represented by; The enhanced lesion ofGlioma recurrence group with normal brain lesion ratios and the enhanced lesion ofradiation brain injury group with normal brain lesion ratios in the fast adc bi ratio andfraction of fast adc bi have significant statistical difference (p=0.014, p=0.005). Theapplication of multi-b-value diffusion-weighted imaging can help identify gliomarecurrence and radiation injury. Objective To investigate the diffusion tensor magnetic resonance imaging (Diffusionweigthed and imaging, DTI) in the evaluation glioma postoperative radiation therapyclinical value in the white matter damage.Materials and methods from December2011to May2013, a total of three cases in thePeople’s Liberation Army General Hospital for treatment, patients were included in aprospective clinical magnetic resonance imaging study approved by the Ethics Committee.GE3.0T750MR imaging system (Signa Excite, GE Healthcare, Milwaukee, WI USA),patients before radiotherapy, radiotherapy (radiotherapy after1week,2weeks,4weeks)after radiotherapy (8weeks,16weeks,24weeks) the corresponding time node DTI scansnormal white matter regions in the performance of conventional MR images, the whitematter of the bilateral frontal and parietal lobes, bilateral lateral ventricles, the corpuscallosum and the press section, bilateral temporal lobe measuring FA values a nd λ1, λ2andλ3value analysis of the differences between the different parts and different nodes DTIparameters and changes.Results3patients in different parts of FA values s howed a gradual downward trend overtime, but no statistically significant differences between the various nodes; different partsbetween λ∥∥although the time to extend showing a gradual downward trend， the λ⊥presents gradual upward trend in each node before radiotherapy numerical comparisons nosignificant statistical difference. Conclusion One week after radiation therapy to radiation-induced brain injury, the DTIparameters FA values and λ∥∥value、λ⊥value Quantitative observation of relativelynormal white matter damage after brain gliomas. Radiation brain injury in the parametersFA values a nd λ∥∥value、λ⊥value on a certain curve, DTI early prediction of radiationbrain injury..