| Objective: To explore the clinical value of 3D arterial spin labeling combined with 1H magnetic resonance spectroscopy,diffusion weighted imaging and other advanced technologies in the preoperative diagnosis of intracranial tumour.Methods: 42 cases of intracranial tumours confirmed by postoperative pathology and clinic diagnosis(13 cases of glioma,12 cases of meningioma,10 cases of metastatic tumour,3cases of acoustic neuroma,2 cases of cavernous hemangioma,1 cases of neurilemmoma,and1 cases of mature teratoma),3.0T magnetic resonance imaging was applied to intracranial tumours patients with conventional and a variety of advanced scanning technology.Three groups of data were measured and collected,first group of data are the maximum tumour blood flow in 3D-ASL perfusion map and cerebral blood flow in contralateral normal white matter,gray matter and symmetric region of tumour;the second group of data are peak values of Cho,NAA,Cr and the corresponding ratio in two regions in 1H-MRS:core of tumour and contralateral normal brain parenchyma of regions of interest;the third group of data were ADC value and r ADC value of tumour body and symmetric region of tumour in DWI.Statistical analysis were conducted for these three groups of data were made respectively.Combined with postoperative pathology and clinical diagnosis,the diagnostic conformity rate between conventional sequence and multimodality MRI were compared by paired X2 test.Results: In conventional sequence,there was no significant difference between high and low grade gliomas about the peritumoral edema and the method of intensification.The perfusion of magnetic resonance showed that the low grade gliomas,perfusion value was lower than the other,and the difference was significant in statistics.The TBF/ symmetricregion of tumours,CBF,TBF/ contralateral white matter,and TBF/ contralateral gray matter,s CBF value of low grade gliomas,high grade gliomas,meningiomas,metastatic tumours were respectively: 1.47 ± 0.49,2.02 ± 0.14,1.37 ± 0.11;3.05 ± 1.32,4.10 ± 1.34,2.59 ± 0.58;2.96 ± 0.54,3.83 ± 0.91,2.54 ± 0.57;2.64 ± 0.43,3.64 ± 0.78,2.27 ± 0.53.There was no significant difference in the perfusion value of high grade gliomas compared with meningiomas and metastatic tumours.1H-MRS showed the Cho/Cr and Cho/NAA metabolites ratios of the the core and peritumoral of tumours,in the gliomas were higher than those in normal brain parenchyma,and the ratios of peritumoral metabolites in gliomas were higher than those in the other two tumours.The ratios of Cho/NAA in the core of meningiomas were significantly higher than those of the two other tumours.The ratios of NAA/Cr in gliomas and metastatic tumors were higher than those in meningiomas.The peak value of NAA/Cr in metastatic tumor and meningioma peritumor were of no significance compared with normal brain parenchyma.The diffusion map showed that the core ADC values of metastatic tumours and meningiomas were lower than those of low-grade gliomas,and the difference was statistically significant.There was no significant difference in ADC values between metastatic gliomas and high-grade gliomas.Conclusion: 3D-ASL,1H-MRS,DWI and other advanced technologies can be used as an important supplement to conventional MRI.3D-ASL,DWI and1 H MRS resectively plays an important role in the classification diagnosis of glioma,the differential diagnosis of intracranial tumors and the determination of tumor boundaries.The combination of all of them can be used as a significant reference for the diagnosis and differential diagnosis of common intracranial tumour. |
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