The value of multimodal magnetic resonance imaging in the differential diagnosis of glioma recurrence and radiation brain injury

Objective 　To explore the application of a combination of diFFusion weighted imaging (DWI), perfusion weighted imaging (PWI) and magnetic resonance spectroscopy (MRS) in the differential diagnosis of glioma recurrence and radiation brain injury. Methods　The clinical and imaging data of 32 patients were retrospectively analyzed, including 15 cases of glioma recurrence and 17 cases of radiation brain injury, admitted from Jan. 2011 to Dec. 2013 in General Hospital of Beijing Command. The DWI, PWI and MRS data of the 32 patients were retrospectively analyzed. The following values were compared between abnormal enhancement area and contralateral normal area: magnetic resonance apparent diFFusion coeFFcient (ADC), relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), choline/creatine (Cho/Cr) and choline/N-acetyl aspartate (Cho/ NAA) ratio. Results　No statistical significance of ADC and rMTT values was found between glioma recurrence group and radiation brain injury group (P>0.05); The maximum and average rCBF and rCBV values were significantly higher in glioma recurrence group than in radiation brain injury group (P 0.05). The ratios of Cho/Cr and Cho/NAA were higher in glioma recurrence group than in radiation brain injury group (P<0.05). The diagnostic sensitivity of PWI to glioma recurrence was 80.0%, of MRS was 73.3%, and of PWI combined with MRS was 93.3%. The diagnostic sensitivity of PWI to radiation brain injury was 82.4%, of MRS was 70.6%, and of PWI combined with MRS was 88.2%. Conclusion　Combined application of multimodal magnetic resonance imaging technology may improve the diagnostic accuracy to glioma recurrence and radiation brain injury, thus provide a good guidance for clinical treatment. DOI: 10.11855/j.issn.0577-7402.2015.11.13