ObjectiveTo analyze the differential diagnostic value of multi sequence MRI in high-grade gliomas (HGG) and solitary brain metastases (SBM).MethodsA retrospective analysis was conducted on 60 patients with HGG and SBM treated in our hospital. Among them, 34 patients with HGG were included in the HGG group, and 26 patients with SBM were included in the SBM group. All patients underwent routine MRI scans, including T₂WI, T₁WI, FLAIR, T₁ enhanced scans, and diffusion-weighted imaging (DWI) scans. The signal detection of routine MRI scans and DWI scans, as well as the apparent diffusion coefficient (ADC) and relative apparent diffusion coefficient (rADC), were analyzed, and the ROC curve was used to evaluate their differential diagnostic value for HGG and SBM.ResultsThere was no statistically significant difference in the signal intensity of T₁WI and T₂WI between the HGG group and the SBM group (P>0.05). The high signal intensity of T₁WI enhancement, T₂WI-FLAIR plain scan, and T₂WI-FLAIR enhancement in the HGG group (73.58% vs 11.54%, 70.59% vs 7.69%, 91.18% vs 15.38%) was higher than that in the SBM group (χ²: 22.748, 23.735, 34.821, P<0.05). The peritumoral edema areas in both HGG and SBM groups showed high ADC signal and low DWI signal, while the tumor parenchyma areas showed high DWI signal. The ADC signal intensity in the tumor parenchyma area of HGG group was not statistically significant compared to SBM group (P>0.05). There were no statistically significant differences on ADC, rADC of the tumor parenchyma areas and the normal area of the opposite side of the tumor between HGG group and SBM group (P>0.05), while the ADC, rADC in the peritumoral edema area of the HGG group were lower than those in the SBM group (t: 5.332, 6.663, P<0.05). The ROC curve analysis showed that the AUC of ADC, rADC, and the model for differential diagnosis of HGG and SBM in the peritumoral edema area were 0.829, 0.867, and 0.983, respectively. The AUC of the model for differential diagnosis of HGG and SBM was higher than that of the individual differential diagnosis of ADC and rADC in the peritumoral edema area (P<0.05).ConclusionT₁WI enhancement, T₂WI-FLAIR plain scan, T₂WI-FLAIR enhancement, and ADC and rADC in the peritumoral edema area can differentiate HGG and SBM. The model constructed based on this has some assistance differential diagnostic value for HGG and SBM.