The Primary Study Of CT Spectral Imaging Combined With ~1H-MR Spectroscopy In Diagnosing Of Pathologic Grading And Type Of Meningiomas

Objective:To evaluate the value of CT spectral imaging combined with 1H-MR spectroscopy(1H-MRS) in predicting of pathologic grading and types in meningiomas. From the Radiographic view to provide more information for grading and tapying of meningiomas. And then provide reference information for the tumor of surgery approach, prognosis assessment, efficacy evaluation and recurrence prediction.Methods:The object of study for the period from 2014 March to 2015 January.diagnosed clinically and pathologically diagnosed as meningioma patients were scaned by the energy spectrum of CT and 3.0T magnetic resonance spectroscopy in the preoperative.48 cases of patients with spectral CT scanning,43 cases of patients with MR spectroscopy scanning,llcases of patients with spectral CT combined with MR spectroscopy scanning. Application respectively the quantitative parameters of dual energy spectral CT and MR spectroscopy of analyzed meningioma grading type and assess the diagnostic performance of quantitative parameters.Results:1.The analysis results of CT energy spectrum characteristic parameter in Meningioma pathologica 1 grading: ① The CT values of meningiomas in the low-keV monochromatic images (40keV-70keV) of benign group were lower than those of malignant group (each P<0.05).In the high-keV monochromatic images (90keV-140keV), the CT values had no significant difference (each P>0.05). ② Comparing spectrue curve of WHO grade Ⅰ and WHO grade Ⅱ meningiomas,Slope K of spectral HU curve of WHO grad Ⅱ meningiomas was higher than that of WHO grde Ⅰ group (P<0.05).③ Comparing Effective-z of WHO grade Ⅰ and WHO grade Ⅱ meningiomas,they had no Significant differences(P>0.05).④ The comparison results of the base material concentration value, including Calcium (Iodine)、Calcium (Water)、Iodine (Calcium)、 Iodine (FAT)、 Iodine (Water)、FAT (Iodine)、FAT (Water)、Water (Calcium)、Water (FAT)、 Water (Iodine) of meningiomas in two groups had no significant difference (P>0.05).⑤ ROC curve analysis showed the 40 keV monochromatic images in differentiation of WHO grade I and grade II meningioma had high sensitivity (100%) and specific degrees (86%),The area under the ROC curve was 0.93.2.The analysis results of CT energy spectrum characteristic parameter in WHO grade I Meningioma pathological type: ①Compared with the spectrum CT value between 3 subtypes of WHO grade I meningiomas showed the 40 keV monochromatic images had Obvious difference. Pairwise comparison results showed in low energy (40-60KeV) level, The spectrum CT values were significantly different between the fiber meningioma and meningothelial meningioma, meningothelial meningioma and transitional meningoma, fiber meningioma and transition meningioma. (P<0.05) But there was no significant difference between fiber meningioma and meningothelial meningioma, meningothelial meningioma and transitional meningioma, fiber meningioma and transition meningioma in the high- energy level (70-140KeV) (P> 0.05).②The slope λ of the spectrum curve and Effective-z analysis showed no significant difference between the fiber type, skin type, transitional type of meningioma. ③ The comparison results of the base material concentration value of Meningiomas between different pathological types, including Calcium (Iodine)、Calcium (Water)、Iodine (Calcium)、Iodine (FAT)、Iodine (Water)、 FAT (Iodine)、FAT (Water)、Water (Calcium)、Water (FAT)、Water (Iodine) of meningiomas in two groups had no significant difference (P>0.05).3.The analysis results of Magnetic resonance spectroscopy in meningioma pathological grading and type:①NAA concentration and NAA/Cr of in WHO grade Ⅰ and grade Ⅱ meningioma had no significant difference (P>0.05). NAA concentration and NAA/Cr of in WHO grade Ⅰ and grade Ⅱ meningioma had no significant difference (P>0.05).But Cho concentration、Cr concentration、 NAA/Cho and Cho/Cr of meningiomas in two groups had significant difference(P<0.05). ② Compared with NAA concentration、Cho concentration、NAA/Cho、NAA/Cr、Cho/Cr between 3 subtypes of WHO grade Ⅰ meningiomas showed there was no significant difference (P>0.05),but Cr concentration had significant difference(P<0.05). The Cr concentration and Cho/Cr value of meningiomas between meningothelial and fiber type had significant difference. The Cr concentration and NAA/Cr value of meningiomas between meningothelial and transition type had significant difference(P<0.05). The Cho/Cr value of meningiomas between fibe and transition type had significant difference(P<0.05).③ROC curve analysis showed the Cr concentration in differentiation of WHO grade Ⅰ and grade Ⅱ meningioma had high sensitivity (100%) and specific degrees (83%),The area under the ROC curve was 0.91.Conclusion:1. Spectral CT imaging in grading diagnosis of meningioma, the low energy level (40-70KeV) of single energy CT values and energy spectrum curve slope of λ had significant value. In the type diagnosis of meningioma, the low energy level (40-60KeV) of single energy CT values has the significance in the differential diagnosis of WHO grade Ⅰ meningioma subtypes.2. The value of parameter MR spectroscopy, Cho, Cr, NAA/Cho, Cho/Cr concentration can be classified assessment of meningiomas.In the diagnosis of meningioma subtypes, the concentration of Cr, Cho/Cr, NAA/Cr has its own specific,to help in the diagnosis of meningioma type to provide more accurate information.3. CT spectral imaging combined with MR spectroscopy in grading diagnosis of meningiomas, low energy (40-70KeV) level interval corresponding to the single energy CT value and slope, the concentration of Cho was significantly lower than that of WHO grade Ⅱ meningioma, and the concentration of Cr was significantly higher than that of WHO Ⅱ, the combination of the two can be more accurate classification in diagnosis of meningioma.