Objective To investigate the value of MRI features in the preoperative differential diagnosis between suprat-entorial pleomorphic xanthoastrocytoma(PXA)and pilocytic astrocytoma(PA).Methods Twenty-nine pathologically-confirmed PXA patients and twenty-six PA patients were retrospectively recruited.Clinical and MR imaging data,including age,gender,tumor site,size,predominant radiologic pattern,contrast enhancement pattern,peritumoral edema and presence of adjacent leptomeningeal involvement,were collected and assessed.Logistic regression analysis was performed on MRI characteristics,and the diagnostic efficacy of MRI signs with P＜0.05 in univariate analysis and different combinations in differentiating PXAs from PAs was further calculated.The receiver operating characteristic curve was used to evaluate the di-agnostic efficiency and calculate the area under the curve(AUC).Results There were statistically significant differences in age,location,size and peritumoral edema between the PXA group and the PA group(all P＜0.05).Multivariate logistic regression showed that tumor site,size,and peritumoral edema were all highly valuable in differentiating them.Tumor size showed the highest sensitivity(88.5％),while the combination of location and peritumoral edema exhibited the highest spe-cificity(89.7％).The combination of location,size,and peritumoral edema demonstrated the highest differential diagnostic efficacy,with an area under the curve(AUC)of 0.858,sensitivity of 73.1％,and specificity of 86.2％.Conclusion There are differences in tumor site,size,and degree of peritumoral edema between PXA and PA,therefore preoperative MRI may assist in the differential diagnosis.
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