SUPRATENTORIAL GLIOMAS: IMAGING CHARACTERISTICS AND THE VALUE OF 3 TESLA MRI IN GRADING
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Abstract
This study was conducted with the aim of evaluating the value of 3 Tesla magnetic resonance imaging (MRI) using conventional MRI and advanced MRI techniques including: perfusion MRI, spectroscopy MRI, and diffusion tensor imaging (DTI) in grading gliomas. The study was conducted on 115 patients. Supratentorial gliomas in these patients were examined using MRI, followed by surgery, and the histopathological results after surgery were obtained at Viet Duc Hospital from June 2021 to September 2024. The study assessed the imaging characteristics of the tumors on conventional MRI and quantified the parameters on perfusion MRI, spectroscopy MRI, and diffusion tensor imaging of the tumor and peritumoral regions, thereby calculating the discriminatory value between low-grade gliomas (LGG) and high-grade gliomas (HGG) based on the imaging features and quantitative values. Results: The average size in all three dimensions of the HGG group tended to be larger than that of the LGG group. The majority of HGG masses showed strong contrast enhancement (63.9%), in contrast to the non-enhancing pattern predominantly observed in LGG (78.1%). Solid gliomas accounted for the largest proportion (43.5%), followed by mixed type (36.5%), and cystic type was the least common (20%). Hemorrhage and tumor necrosis were more frequently observed in HGG. Perfusion MRI showed statistically significant differences in rCBV and rCBF in the tumor and peritumoral regions. On spectroscopy MRI, HGG showed higher Cho/NAA and Cho/Cr ratio, and a lower NAA/Cr ratio compared to LGG in the tumor region. In the peritumoral region, HGG showed lower NAA/Cr ratio, and higher Cho/NAA and Cho/Cr ratios compared to LGG. DTI revealed differences in the FA index in the tumor and peritumoral regions between the two groups. Conclusion: The features of tumor size, tumor contrast enhancement, tumor structure, presence of hemorrhage, and intratumoral necrosis on conventional MRI; rCBV and rCBF values; Cho/NAA, Cho/Cr, NAA/Cr and FA in the tumor and peritumoral regions on advanced MRI have discriminatory value between LGG and HGG.
Article Details
Keywords
3 Tesla MRI, advanced MRI, quantitative MRI, glioma, grading
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