JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (4): 65-70.doi: 10.6040/j.issn.1671-7554.0.2014.451

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Value of 3.0T 1H-MRS in the differential diagnosis of high-grade brain gliomas and solitary metastatic tumors

YANG Hui1,2, LI Wanhu1, CHEN Yueqin3, GUO Mujie3, XU Liang1, WU Yufen2   

  1. 1. MR Division, Shangdong Tumor Hospital, Jinan 250117, Shandong, China;
    2. CT Division, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong, China;
    3. CT Division, Affiliated Hospital of Jining Medical University, Jining 272029, Shandong, China
  • Received:2014-07-09 Revised:2015-03-09 Online:2015-04-10 Published:2015-04-10

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Abstract: Objective To assess the value of MR spectroscopy (MRS) in differentiating solitary brain metastases from high-grade gliomas on the basis of differences in metabolite ratios in the intratumoral and peritumoral region. Methods A total of 23 patients with high-grade gliomas and 15 patients with solitary brain metastases underwent MRI and 1H-MRS before surgery. A variety of metabolite peaks including Cho, Cr, NAA and Lip/Lac were detected in the peritumoral areas and the tumoral core. The differences in the metabolite ratios were analyzed statistically. Cutoff values of Cho/Cr, Cho/NAA, and NAA/Cr ratios in the peritumoral edema, as well as Cho/Cr ratios in the tumoral core for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results Significant differences were noted in the peritumoral Cho/Cr, Cho/NAA, and NAA/Cr ratios between high-grade gliomas and metastases. ROC analysis demonstrated a cutoff value of 1.33 for peritumoral Cho/Crratio to provide sensitivity, specificity and the area under the curve(AUC) of 73.9%, 100%, 89.3%, respectively. By using a cutoff value of 1.25 for peritumoral Cho/NAA ratio, the sensitivity was 76.2%, the specificity was 100%, and the AUC was 90.7%. Conclusion MRS can differentiate high-grade gliomas from solitary brain metastases, especially with peritumoral measurements and analysis of ROC curve.

Key words: Magnetic resonance spectroscopy, Cranial defects, Homochronous operation, Brain metastases, High-grade gliomas, Drocephalus, Predictive nursing intervention

CLC Number: 

  • R574
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