Application value of DCE-MRI,IVIM-DWI and MRS in the Differential Diagnosis of Postoperative Recurrence and Pseudoprogression of Glioma
Objective To analyze the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)and magnetic resonance spectroscopy(MRS)in the differential diagnosis of postoperative recurrence and pseudoprogression(PP)of glioma.Methods Seventy-two patients with glioma who underwent concurrent radiochemotherapy in the hospital were selected.All patients were examined with DCE-MRI,IVIM-DWI and MRS after 3 months of radiochemotherapy.According to the second surgical and pathological results or follow-up results,the patients were divided into recurrence group and PP group.The transfer coefficient(Ktrans),rate constant(Kep),volume fraction of extravascular extracellular space(Ve),apparent diffusion coefficient(ADC),perfusion fraction(f),true diffusion coefficient(D),false diffusion coefficient(D*),choline(Cho)/creatine phosphate(Cr)and Cho/N-acetylaspartic acid(NAA)were compared between the groups.The value of the combination of these indicators in the differential diagnosis of postoperative recurrence and PP was analyzed using the receiver operating characteristic(ROC)curve.Results There was no statistically significant difference in Kep,D or D*between the groups(P＞0.05).Ktrans,Ve,f,Cho/Cr and Cho/NAA in the recurrence group were significantly higher than those in the PP group(P＜0.05).ADC value was significantly lower than that in the PP group(P＜0.05).ROC analysis found that the AUC values of Ktrans,Ve,f,ADC,Cho/Cr,Cho/NAA alone and in combination were 0.688,0.821,0.835,0.679,0.801,0.785 and 0.988.The AUC of combined diagnosis was the largest,and the sensitivity and specificity in the differential diagnosis of postoperative recurrence and PP were 95.32％and of 93.07％.Conclusion The combined use of DCE-MRI,IVIM-DWI and MRS is very helpful for differential diagnosis of postoperative recurrence and PP of glioma,and can provide reliable guidance for clinical practice.
NETL
NSTL
万方数据
