DWI、DTI联合常规MRI可提高高级别脑胶质瘤的诊断准确度

目的探讨扩散加权成像（DWI）、扩散张量成像（DTI）及常规MRI对高级别脑胶质瘤的诊断价值。方法选取2018年10月~2020年7月医院收治的65例脑胶质瘤患者作为研究对象。手术取病理组织标本，根据病理结果分为高级别脑胶质瘤组和低级别脑胶质瘤组。术前行MRI检查，扫描序列为T1WI、T2WI、DWI、DTI。分析不同级别脑胶质瘤MRI图像，比较不同级别脑胶质瘤的表观弥散系数（ADC）和各向异性分数（FA）值。分析瘤体ADC_DWI、ADC_DTI、FA诊断高级别脑胶质瘤阈值、敏感度及特异性。结果65例患者经术后病理检查均确诊为脑胶质瘤，其中低级别脑胶质瘤29例，高级别脑胶质瘤36例；不同级别脑胶质瘤瘤周ADC_DWI、ADC_DTI和FA值差异无统计学意义（P > 0.05）；不同级别脑胶质瘤瘤体FA值差异无统计学意义（P > 0.05）。高级别脑胶质瘤瘤体ADC_DWI和ADC_DTI值低于低级别脑胶质瘤（P < 0.05）。ADC_DWI、ADC_DTI、FA诊断高级别脑胶质瘤的AUC分别为0.775、0.817、0.716。DWI和DTI联合检测诊断高级别脑胶质瘤敏感度和特异度较高，AUC为0.903（P < 0.05）。结论常规MRI联合DWI、DTI有助于提高脑胶质瘤诊断和病理分级准确度。 

Diagnostic value of diffusion weighted imaging,diffusion tensor imaging and conventional MRI in high-grade glioma

ObjectiveTo investigate the diagnostic value of diffusion weighted imaging (DWI), diffusion tensor imaging (DTI) and conventional MRI in high-grade glioma.MethodsSixty-five patients with glioma in our hospital from October 2018 to July 2020 were selected. According to the pathological results, they were divided into high-grade glioma group and low-grade glioma group. MRI was performed before operation, and the scanning sequences were T1WI, T2WI, DWI and DTI. The MRI images of different grades of gliomas were analyzed, and the apparent dispersion coefficient (ADC) and fractional anisotropy (FA) values of different grades of gliomas were compared. The diagnostic threshold, sensitivity and specificity of ADC_DWI, ADC_DTI and FA were analyzed. The specificity of ADC_DWI, ADC_DTI and FA in the diagnosis of high-grade glioma were analyzed.ResultsAll 65 patients were diagnosed as glioma by postoperative pathological examination, including 29 cases of low-grade glioma and 36 cases of high-grade glioma. The difference in ADC_DWI, ADC_DTI and FA values among different grades of gliomas were not significant(P > 0.05). The difference in FA between different grades of glioma was not significant(P > 0.05). The values of ADC_DWI, ADC_DTI in high-grade gliomas were significantly lower than those in low-grade gliomas(P < 0.05). The AUC of ADC_DWI, ADC_DTI and FA were 0.775, 0.817 and 0.716, respectively.The sensitivity and specificity of DWI and DTI in the diagnosis of high-grade gliomas were higher, AUC was 0.903(P < 0.05).ConclusionConventional MRI combined with DWI and DTI can improve the accuracy of diagnosis and pathological grading of glioma.