Objective To analyze the correlations between multimodal MRI examination parameters – apparent diffusion coefficient (ADC), cerebral blood flow (CBF), and choline (Cho)/creatine (Cr)—and microvessel density (MVD) in patients with glioma, as well as the prognostic value of these parameters.

Methods The medical records of 200 patients diagnosed with glioma at our hospital from January 2019 to January 2024 were retrospectively analyzed. According to the WHO classification, patients were divided into a low-grade group (n = 122) and a high-grade group (n = 78). Patients were further divided into a good prognosis group (n = 114) and a poor prognosis group (n = 86). The Pearson correlation test was used to analyze the relationship between multimodal MRI parameters and MVD in glioma patients. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of multimodal MRI parameters and MVD for high-grade glioma and their predictive value for poor prognosis. The Hosmer-Lemeshow test was used to assess the goodness of fit of the model.

Results The ADC value in the low-grade group was higher than in the high-grade group, while CBF, Cho/Cr, and MVD were lower in the low-grade group (P < 0.05). The ADC value in the good prognosis group was higher than in the poor prognosis group, while CBF and Cho/Cr values were lower in the poor prognosis group (P < 0.05). ADC was negatively correlated with MVD in glioma patients (r = －0.226, P = 0.001); CBF and Cho/Cr were positively correlated with MVD (r = 0.235 and 0.396, P = 0.001 and < 0.001, respectively). The AUCs of ADC, CBF, Cho/Cr, and MVD for diagnosing high-grade glioma were 0.870, 0.696, 0.926, and 0.950, respectively. The combined AUC of these four parameters was 0.997. For prognosis prediction based on multimodal MRI parameters, the combined AUC of ADC+CBF+Cho/Cr was 0.876, while the AUCs of ADC, CBF, and Cho/Cr alone were 0.718, 0.688, and 0.808, respectively. The Hosmer-Lemeshow test showed that the combined model (ADC + CBF + Cho/Cr) fit was good (χ² = 8.570, P = 0.380), indicating that the combined prediction model had high accuracy.

Conclusion ADC, CBF, and Cho/Cr have a weak correlation with MVD in glioma patients. The combination of these four parameters has high value in diagnosing high-grade glioma, and the combination of the first three parameters has higher predictive value for patient prognosis.