The Contrastive Study Of Diffusion Kurtosis Imaging And Magnatic Resonance Spectroscopy In Pathological Grading Of Glioma

The pathological grading of glioma is closely related to its clinical treatment and prognosis evaluation.Especially,the accurate grading of grade II and III gliomas is of great guiding significance for the selection of clinical treatment options.Preoperative assessment of glioma grade and infiltration is of great importance to the selection of clinical treatment options and prognosis of the disease.The purpose of this study is to compare the effect of diffusion kurtosis imaging(DKI)and magnetic resonance spectroscopy imaging(MRS)on preoperative grading of gliomas.Materials and MethodsThis study selected the October 2017 to 2018 year in November treated in the Department of Neurosurgery of Fuzhou 900 Hospital of the Joint Logistics Team,48 cases of clinically suspected glioma lesions underwent conventional MR scan,DKI and MRS.All patients underwent surgical treatment within two weeks after MRI examination.The pathological classification was based on WHO 2016 classification of central nervous system tumors.In this study,German Siemens Skyra 3.0T superconducting magnetic resonance scanner was used.Conventional MR scanning examination,DKI scan and MRS scan and enhanced scan in the end,to avoid the impact of the results of MRS.Processing MRS and DKI respectively by using equipment workstation and DKE software.Finally,MK,AK,RK,Cho/Cr and Cho/NAA of high and low grade gliomas were compared,P < 0.05 showed that there was significant difference.ROC curve was used to analyze the sensitivity,specificity and optimal diagnostic threshold of each index in grading diagnosis of glioma.The test level was a =0.05.ResultsPostoperative pathological grading showed that of the 27 patients,9 were low grade gliomas and 18 were high grade gliomas.The values of MK,AK,RK,Cho/Cr and Cho/NAA in high grade gliomas were 0.80±0.15、0.62±0.13、0.68±0.13、5.12±3.71 and 10.51±7.09,respectively.The values of MK,AK,RK,Cho/Cr and Cho/NAA in low grade gliomas were 0.44±0.11、0.46±0.14、0.51±0.15、0.68±0.13 and 4.29±3.26,respectively.There were significant differences in MK、AK、RK between high-grade glioma and low-grade glioma,Cho/Cr and Cho/NAA.The results of ROC curve analysis show that the area under the curve of MK value is the largest,0.951,P <0.001,and the optimum critical value is 0.5033;Then RK,AK,Cho/NAA and Cho/Cr were 0.827,0.802,0.827 and 0.796,respectively,P were less than 0.05,and the optimal critical values were 0.6789,0.5640,6.5296 and 2.7685,respectively.ConclusionThe MK 、 AK 、 RK of Diffusion kurtosis imaging,Cho/NAA and Cho/Cr of magnetic resonance spectroscopy are valuable for differential diagnosis of high and low grade gliomas,while DKI,especially MK value,has greater reference significance for the clinical treatment and prognosis of gliomas.