脑胶质瘤患者MRS测量值与病理分级的关系及对术后复发的预测价值OACSTPCD

Objective To analyze the relationship between magnetic resonance spectroscopy(MRS)and pathological grade and its value in predicting postoperative recurrence in patients with glioma.Methods A total of 69 patients with brain glioma confirmed by surgical pathology from November 2019 to November 2020 were selected.According to the pathological grade,grade Ⅰ(12 cases)and grade Ⅱ(20 cases)were included in the low-grade group,grade Ⅲ(23 cases)and grade Ⅳ(14 cases)were included in the high-grade group.All patients underwent MRS Examination before surgery,and the values of metabolites N-acetylaspartate(NAA),choline(Cho)and creatine(Cr)in the lesion area were recorded,and NAA/Cho,NAA/Cr and Cho/Cr were calculated.The NAA/Cho,NAA/Cr,Cho/Cr values of the two groups were compared.The relationship between the measured values of MRS(NAA/Cho,NAA/Cr,Cho/Cr)and pathological grade,and the independent risk factors for postoperative recurrence of brain glioma were analyzed,and the value of MRS in predicting postoperative recurrence of brain glioma were investigated.Results Compared with the low level group,the NAA/Cho,NAA/Cr values in the high level group were lower,and Cho/Cr values were higher(P<0.05).Spearman correlation analysis showed that NAA/Cho and NAA/Cr were negatively correlated with pathological grade in glioma patients,while Cho/Cr was positively correlated with pathological grade(P<0.05).Of the 69 patients,2 cases were lost to follow-up during follow-up,and 19 cases(28.36％)of the remaining 67 patients with glioma recurred after surgery.Compared with the non-recurrence group,the recurrence group had higher pathological grade Ⅲ to Ⅳ,tumor diameter>4.5 cm,Cho/Cr value,and lower NAA/Cho,NAA/Cr value(P<0.05).The pathological grade Ⅲ-Ⅳ,tumor diameter>4.5 cm,low NAA/Cho value,NAA/Cr value and high Cho/Cr value were independent risk factors for postoperative recurrence of glioma patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NAA/Cho value,NAA/Cr value and Cho/Cr value in predicting postoperative recurrence of glioma patients were 0.792,0.731 and 0.847,respectively,and the AUC of postoperative recurrence of glioma patients predicted by the combination of the three values was 0.904.It was significantly higher than that detected by three separate tests(P<0.05).Conclusion NAA/Cho and NAA/Cr are negatively correlated with pathological grade,while Cho/Cr is positively correlated with pathological grade,and the combined detection of NAA/Cho,NAA/Cr and Cho/Cr values has high predictive value for postoperative recurrence in glioma patients.