| Objective: To discuss ~1H-MR spectroscopy study in predicting the value of each grade range and grading of glioma invasion.Material and Methods: A restrospective analysis of the preoperative biopsy or posoperative pathology confirmed glioma in 33 cases,accroding to the standard of WHO(2007)diagnosis of cerebral glioma grading,it is divided into 4 levels, and all patients got MRI and ~1H-MR spectroscopy as a preoperative examination. In the tumor area, peritumoral region and normal area use the ~1H-MR spectroscopy analysis. Compare the ratio difference in all grade glioma of different regional metabolite NAA, Cho, Cr and NAA/Cho, NAA/Cr, Cho/Cr. Results: As 1H-MRS metabolites in all gliomas of different regions through comparison found that there were significantly difference of grade I glioma in the peritumoral region and the tumor area Cho,Cho/Cr, NAA/Cho(P<0.025), there were significantly difference in peritumoral region and the normal brain tissue Cho, Cr, NAA/Cho, Cho/Cr ratio(P<0.025). There were respectively significantly difference(P<0.025) in grade II glioma in peritumoral region and the tumor area NAA, NAA/Cho, NAA/Cr ratio. There were statistically significantly difference in peritumoral region and the normal brain tissue Cho, NAA, Cr, NAA/Cho,NAA/Cr, Cho/Cr ratio(P<0.025). Grade III glioma in peritumoral region and the tumor area Cho, NAA, NAA/Cho, NAA/Cr, Cho/Cr ratio were significantly difference(P<0.025),the peritumoral region and normal area of Cho, NAA, Cr, NAA/Cho, NAA/Cr, Cho/Cr ratio of the difference were significantly(P<0.025). Grade Ⅳglioma in peritumoral region and the tumor area Cho, NAA, NAA/Cho, NAA/Cr, Cho/Cr ratio were significantly difference(P<0.025), the peritumoral region and normal area of Cho, NAA, Cr, NAA/Cho,NAA/Cr, Cho/Cr ratio of the difference were significantly(P<0.025). The ratio of Cho/Cr and NAA/Cho were correlated with the pathological grade(P<0.05)and the ratio of NAA/Cr and NAA/Cho were decreased gradually, and the ratio of Cho/Cr was graduallyincreased(P<0.05).Conclusion: The ~1H-MR spectroscopy analysis has a certain significance to predict the level of glioma invasion and determine the grading of glioma before surgery. It also has important significance to determine the surgical plan, the scope of resection, reduce the recurrence and prognosis of the patients after surgery. |
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