Preoperative assessment using multimodal functional magnetic resonance imaging techniques in patients with brain gliomas

Abstract

Aim: To evaluate the value of magnetic resonance spectroscopy (MRS), blood oxygen level-dependent imaging (BOLD) and diffusion tensor imaging (DTI) for preoperative assessment in patients with brain gliomas.

Material and methods: Twenty-three consecutive glioma patients underwent MRS, BOLD and DTI before operation. The characteristics of images were analysed according to histopathological results.

Results: There is significant elevation of the choline (Cho) /creatine (Cr) ratio, Cho peak and depression of the N-acetylaspartate (NAA) peak in gliomas. Elevation of the Cho/Cr, Cho/NAA ratio and the presence of a lipids peak, were consistent with high-grade malignancy. A motor activation scan was achieved by using a motor task paradigm in 20 patients. Deformation and displacement of the motor activations was found in 5 cases. The margin of tumor and peritumoural white matter tracts were identified using apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps. Three patterns of white matter tracts alteration were identified: displacement, infiltration, and disruption. In all 23 patients, the tumors were completely resected in 6 patients, subtotal resected in 8 patients, partial resected in 9 patients. No secondary neurological deficit was occurred in all patients after operation.

Conclusion: The combination of MRS, BOLD, and DTI techniques allows appropriate presurgical planning of brain gliomas.