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• Clinical Article •
The value of DKI and DTI in the differential diagnosis of low-grade gliomas and encephalitis
ZHAO Kai  MA Xiaoyue  CHENG Jingliang  GAO Ankang  BAI Jie  WANG Peipei  ZHAO Guohua  GAO Eryuan  QI Jinbo 

Cite this article as: ZHAO K, MA X Y, CHENG J L, et al. The value of DKI and DTI in the differential diagnosis of low-grade gliomas and encephalitis[J]. Chin J Magn Reson Imaging, 2024, 15(2): 1-6, 55. DOI:10.12015/issn.1674-8034.2024.02.001.


[Abstract] Objective To evaluate the value of MR diffusion kurtosis imaging (DKI) and diffusion-tensor imaging (DTI) in differentiating low-grade gliomas from encephalitis.Materials and Methods The imaging data of 58 patients with either low-grade glioma or encephalitis were retrospectively collected. All patients underwent routine MRI and DKI sequence scans before surgery or conservative treatment. The DKI images were processed with NeuDiLab software to obtain the parameter maps of DKI-based mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK), as well as DTI-based mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) and fractional anisotropy (FA) and diffusion images of b=0 s/mm2 (B0). The volumes of interest (VOIs) of the tumor were manually delineated on the B0 image with ITK-SNAP software and were registered to other parametric maps. The mean values of each parameter were extracted with FAE software. Patients were divided into glioma group and encephalitis group according to pathological examination or cerebrospinal fluid examination results. The chi-square test, independent samples t test and Mann-Whitney U test were used to compare the general data, routine MRI findings and diffusion parameters between the two groups. Cohen's d values were calculated to evaluate the effect sizes of diffusion parameters. The receiver operating characteristic (ROC) curve was drawn to calculate the area under the curve (AUC), sensitivity, specificity and accuracy. The DeLong test was used to compare the differential diagnostic performance of diffusion parameters.Results A total of 51 patients were included in the study, including 29 patients with low-grade gliomas and 22 patients with encephalitis. RK demonstrated the best performance in distinguishing low-grade gliomas from the encephalitis group, with an AUC of 0.878. When the threshold was set at 0.662, the sensitivity was 72.7%, and the specificity was 89.7%. The DeLong test indicated that the diagnostic performance of the DKI model was significantly superior to DTI.Conclusions DKI is helpful in the differential diagnosis of low-grade gliomas and encephalitis.
[Keywords] glioma；encephalitis；magnetic resonance imaging；diffusion kurtosis imaging；diffusion tensor imaging

ZHAO Kai   MA Xiaoyue   CHENG Jingliang*   GAO Ankang   BAI Jie   WANG Peipei   ZHAO Guohua   GAO Eryuan   QI Jinbo  

Department of Magnetic Resonance, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China

Corresponding author: CHENG J L, E-mail: fccchengjl@zzu.edu.cn

Conflicts of interest   None.

Received  2023-08-02
Accepted  2024-01-15
DOI: 10.12015/issn.1674-8034.2024.02.001
Cite this article as: ZHAO K, MA X Y, CHENG J L, et al. The value of DKI and DTI in the differential diagnosis of low-grade gliomas and encephalitis[J]. Chin J Magn Reson Imaging, 2024, 15(2): 1-6, 55. DOI:10.12015/issn.1674-8034.2024.02.001.

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