The Study Of Clinical Applications Of ～1H-MRS In Brain Gliomas

Objective: (1)To evaluate the findings of ~1H-MRS and clinical applications of ~1H-MRS; (2)To explore the correlation between the differentiation of ~1H-MRS and the pathological grading, tumor invasion of gliomas.Materials and methods: 36 patients of gliomas were studied(17 male, 19 female, mean age 35.6 years), all of them underwent surgery and were approved by pathology, consisting of 25 cases of Low-grade gliomas ( 9 cases of grade I , 16 cases of grade II), 11 cases of High-grade gliomas (5 cases of gradeIII , 6 cases of gradelV). The 36 patients underwent ~1H-MRS before surgery and all ~1H-MRS were gained on plain MRI scan. Muitiple voxel Proton magnetic resonance spectroscopy was performed on a 1.5T MR scanner using pointed-resolved surface coil spectroscopy(PRESS), the variety of metabolite peaks were detected in different areas. By exploring the correlation between ~1H-MRS and the pathological grading, tumor invasion of gliomas, to evaluate the clinical worthiness of ~1H-MRS in preoperative diagnosis, pathologic grade, differentiation,and to foretell the patient's prognosis of gliomas.Results: ?The findings of !H-MRS: lightly decreased Cr , distinctly decreased NAA and distinctly increased Cho in gliomas. (2) Significant differences between Low-grade gliomas and normal tissue in contralateral brain hemispheres, High-grade gliomas and normal tissue in contralateral brain hemisphereswere found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho(P<0.01), Significant differences between Low-grade gliomas and High-grade gliomas were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho(P<0.05). (3)Significant differences between peritumoral edema of gliomas and spectra of tumor, peritumoral edema of gliomas and normal tissue in contralateral brain hemispheres were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho(P<0.05). ?Significant differences between peritumoral nonedema of gliomas and spectra of tumor were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho(P<0.05); Significant differences between peritumoral nonedema of gliomas and normal tissue in contralateral brain hemispheres were found in the ratios of NAA/Cr and NAA/Cho(P<0.05); but there were no significant differences in the ratios of Cho/Cr (P > 0.05). ?Significant differences in spectra of tumor, area around tumors between the peritumoral edema and nonedema group of gliomas were found in the ratios of NAA/Cho(P<0.05), but there were no significant differences in theratios of NAA/Cr and Cho/Cr (P>0.05). ?There was significant correlation between the ratios of NAA/Cr, Cho/Cr and NAA/Cho and the pathological grading of gliomas, and the ratios of NAA/Cr, Cho/Cr reflected pathologic grade of gliomas relatively steadily; with the grade of gliomas heightened, there was significantly negative correlation in the ratios of NAA/Cr and NAA/ Cho(rs was -0.663, -0.851), and positive correlation in the ratios of Cho/Cr(rs was 0.858). Conclusion:1. The combination of JH-MRS and MRI improves preoperative diagnostic accuracy of gliomas.2. *H-MRS has made it possible to evaluate the grade of gliomas, obtain metabolic information of gliomas and reflect the potential about development of tumor.3. ^-MRS has made it possible to estimate peritumoral edema or nonedema of gliomas implicated by tumor.