The Application Research On DTI In Differential Diagnosis Of Glioma And Meningioma, Grading Of Glioma

Part One The Application Research on DTI and DTT in Differential Diagnosis of Glioma and MeningiomaObjective:To investigate the applied value of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT) in the differential diagnosis in the parenchyma region of glioma and meningioma tumors.Methods:Retrospectively collected 23 cases of intracranial tumor patients, all patients were underwent conventional MRI, DTI and enhancement MRI examination before operation, and confirmed by postoperative pathology, including 12 cases of glioma and 11 cases of benign meningiomas.DTI data of all patients were analyzed, and obtain the mean diffusivity(MD) and fractional anisotropy(FA) figure. Measured tumor area region, the contralateral normal white matter region the MD and FA value, respectively; and compare MD and FA value differences in parenchyma region and normal white matter region, respectively; compare MD and FA value differences of parenchyma region between glioma and meningioma. Using SPSS16.0 statistical analysis, the significance level set at P < 0.05.Deterministic tracking method was adopted to improve the reconstruction of fiber bundles and tumor area, analysis of DTT figure reflected general morphology change of the white matter fiber tracts in the tumor area, around the tumor area and the contralateral normal white matter area.Result:(1)the comparison of MD valuesParenchyma region of glioma goup was higher than contralateral normal white matter region(P<0.05); Parenchyma region of glioma goup was higher than meningioma goup(P<0.05); Meningioma tumor parenchyma compared with the contralateral normal part of MD values was no significant difference(P > 0.05).(2)the FA value comparisonTumor parenchyma of glioma or meningioma was lower than contralateral normal white matter region(P<0.05); Parenchyma region of glioma goup was lower than meningioma group(P < 0.05).(3)the changes of white matter fiber tractsPeritumoral regions of glioma changes of white matter fiber bundles was given priority to with destruction and infiltration; meningioma corresponding area changes of white matter fiber bundles was given priority to with pushing and shifting.Conclusion:Tumor parenchyma region area measurement of MD and FA can help identify glioma and meningioma, DTT can clearly show that anatomical relations of the tumor and adjacent to white matter fiber, and judgement the fibre bundle of infiltration, damage, and help guide clinical surgery, to reduce and avoid damage important white matter fiber tracts.Part Two The Application Value of DTI and DTT in preoperative Grading Patient with gliomaObjective:To explore application value of classification by analyzing the FA value and MD value of the peritumoral regions and parenchyma region, and observing the relationship between tumor and adjacent white matter fiber tracts.Methods:Retrospectively collected 21 cases of intracranial tumor patients, all patients were underwent conventional MRI, DTI and enhancement MRI examination before operation, and confirmed by postoperative pathology, including 10 cases of low-grade glioma and 11 cases of high-grade glioma.DTI data of all patients were analyzed, and obtain the mean diffusivity(MD) and fractional anisotropy(FA) figure. Measured tumor area region, peritumoral regions(solid tumors outside the range of 1-1.5cm), the contralateral normal white matter region the MD and FA value, respectively; and compare MD value differences in parenchyma region between high-grade glioma and low-grade glioma group; and compare FA value differences in parenchyma region between two groups. Using SPSS16.0 statistical analysis, the significance level set at P < 0.05.Deterministic tracking method was adopted to improve the reconstruction of fiber bundles, tumor area, analysis of DTT figure reflected general morphology change of the white matter fiber tracts in the tumor area, around the tumor area and the contralateral white matter area between two groups.Result:(1)the comparison of MD valuesMD values of tumor parenchyma in low-grade glioma group was higher than high-grade glioma group(P<0.05); MD values of peritumoral region between low-grade glioma group and high-grade glioma group was no difference(P<0.05).(2)the comparison of FA valuesFA values of peritumoral region in high-grade glioma group were lower than that of low-grade glioma group(P<0.05). FA values of tumor parenchyma was no significantly difference between two groups(P>0.05).(3)the changes of white matter fiber tractsOn DTT map of high-grade glioma, the white matter tract mainly showed significant invasion and infiltration fiber bundles with relatively ill-defined border, whereas rarefaction and displacement of the white matter tract with well-defined border were showed in low-grade glioma.Conclusion:MD and FA vuale measurement of the substance area and peritumoral region can help identify high and low-grade glioma; DTT can clearly show the situation of different grade glioma on the adjacent white matter fiber tracts, infiltration, damage, and be helpful to guide the operation plan formulation, and to provide important information navigation intraoperative and postoperative follow-up.