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Gliomas grading is important for treatment plan; we aimed to investigate the application of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in gliomas grading, by comparing with the three-dimensional pseudocontinuous arterial spin labeling (3D pCASL). 24 patients (13 high grade gliomas and 11 low grade gliomas) underwent IVIM DWI and 3D pCASL imaging before operation; maps of fast diffusion coefficient ( D   ∗ ), slow diffusion coefficient ( D ), fractional perfusion-related volume ( f ), and apparent diffusion coefficient (ADC) as well as cerebral blood flow (CBF) were calculated and then coregistered to generate the corresponding parameter values. We found CBF and  D   ∗  were higher in the high grade gliomas, whereas ADC,  D , and  f  were lower (all  P  < 0.05). In differentiating the high from low grade gliomas, the maximum areas under the curves (AUC) of  D   ∗ , CBF, and ADC were 0.857, 0.85, and 0.902, respectively. CBF was negatively correlated with  f  in tumor ( r  = −0.619,  P  = 0.001). ADC was positively correlated with  D  in both tumor and white matter ( r  = 0.887,  P  = 0.000 and  r  = 0.824,  P  = 0.000, resp.). There was no correlation between CBF and  D   ∗  in both tumor and white matter ( P  > 0.05). IVIM DWI showed more efficiency than 3D pCASL but less validity than conventional DWI in differentiating the high from low grade gliomas.

Comparison of Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging and Arterial Spin Labeling MR Imaging in Gliomas