Objective To explore the value of diffusion-weighted imaging (DWI) combined with magnetic resonance spectroscopy (MRS) in grading and differentiating gliomas.Methods Between August 2013 and July 2018, 83 patients with brain tumors in our hospital were selectedto receive the image examinations (MRI, DWI, MRS). The clinical data were collected; The ADC values of the affected side and the contralateral side were calculated. NAA, Cho, Cr and other metabolite peaks were measured. Results The ADC value and rADC value of solid components in low grade gliomas were significantly higher than those in high grade gliomas (P<0.05). rNAA in low grade gliomas was significantly higher than that in high grade gliomas; rCho in low grade gliomas was significantly lower than that in high grade gliomas (P<0.05). NAA/Cho and NAA/Cr in low grade gliomas were significantly higher than those in high grade gliomas. Cho/Cr in low grade gliomas was significantly lower than that in high grade gliomas(P<0.05). The rNAA of brain metastasis was significantly higher than that of high grade gliomas (P<0.05). NAA/Cho

and NAA/Cr in metastatic tumors were significantly higher than those in high-grade gliomas (P<0.05). Conclusion The combined application of magnetic resonance DWI and MRS technology has a certain differential diagnosis value for brain tumors, which can classify and qualitatively analyze the malignant degree of tumors, and guide the judgment and treatment. It is worthy of promotion.