Research of diffusion tensor imaging in differential diagnosis of tumor-like inflammatory demyelinating disease and low grade glioma

Objective To investigate the application of diffusion tensor imaging(DTI) in the differential diagnosis of tumor-like inflammatory demyelinating disease(TIDD)and low grade glioma(LGG). Methods Ten cases of TIDD and 15 cases of LGG, verified by operation and pathology performed by using 3.0 T DTI in the First Affiliated Hospital of Chongqing Medical University from January 2012 to February 2012 were retrospectively studied. Apparent diffusion coefficient(ADC) values and fractional (FA) values were measured on the placeholder district and the contralateral normal brain white matter on ADC and FA imaging of each patient and the results were statistically analyzed, the 3D image of white matter fiber was reconstructed, the relationship between lesion area and white matter pathways was observed. Results The ADC and FA values of TIDD in lesion area and the contralateral area were (1.484±0.14)×103 mm2/s, 0.109±0.02 and (0.725±0.05)×103 mm2/s, 0.443±0.08. The ADC and FA values of LGG in lesion area and the contralateral area were (1.368±0.09)×103 mm2/s, 0.163±0.01 and (0.684±0.03)×103 mm2/s, 0.471±0.04. The difference of ADC and FA values in lesion area between TIDD groups and LGG groups was significant compared with the contralateral area (all P values<0.01). The difference of ADC and FA values in lesion area between the two groups was also significant (all P values<0.05). The main features of LGG reconstruction of the fiber image were that the tumor site was obviously compressed and shifted, which was more sparse than the contralateral side. The main performance of TIDD was that the fiber was a little sparse, and there was no obvious interruption and shift. Conclusions The diffusion index of DITT and LGG in DTI shows significant differences, which provides quantitative basis in the differential diagnosis of two diseases. Key words: Demyelinating disease; Tumor-like inflammatory demyelinating disease; Glioma; Diffusion tensor imaging; Magnetic resonance imaging; Apparent diffusion coefficients; Fractional anisotropy