SWI在胶质瘤分级中的应用价值

目的:探讨3.0TSWI在颅内胶质瘤分级中的应用价值。方法:经手术病理证实的20例高级别胶质瘤和12例低级别胶质瘤,均行T2WI、T2FLAIR、T1FLAIR、增强T1FLAIR和SWI。由2位经验丰富的神经影像学医师对SWI和常规MRI序列图像中肿瘤的内部结构进行盲法评定。观察项目包括:肿瘤内出血代谢物、钙化、肿瘤相关静脉的显示,并对病灶内低信号程度评分。结果:大多数低级别胶质瘤瘤内的细线状低信号提示血管结构,而大多数高级别胶质瘤瘤内斑片状及细线状低信号提示出血和血管结构。高级别胶质瘤低信号程度评分高于低级别胶质瘤,2组之间差异有统计学意义(Z=-3.308,P<0.01);胶质瘤级别与肿瘤低信号评分Pearson相关分析呈正相关(r=0.616,P<0.001)。结论:SWI有助于分析胶质瘤内部的细微结构及胶质瘤分级。

The clinical application of susceptibility weighted imaging in evaluating the histopathologic grade of cerebral gliomas

Objective：To evaluate the diagnostic value of susceptibility weighted imaging（SWI）for cerebral gliomas at 3.0 T.Methods：Thirty-two patients with histologically proved cerebral gliomas（20 high-grade and 12 low-grade gliomas）underwent conventional MR imaging（T2WI,T1FLAIR,T2FLAIR,contrasted T1FLAIR）and SWI.All SWI images were reviewed independently by two radiologists who did not know the surgical or pathological results,including：identifying blood products,venous vasculature,calcification in gliomas,and the intratumoral susceptibility signals（ITSS）on SWI were graded.Results：Hypointensity（dotlike or linier）on SWI of WHO Grade 2 tumors indicates vascular structure and that on SWI of higher grade tumors indicates both vascular and hemorrhagic lesions in almost equal numbers.Mean grading scores of ITSS in the tumor were higher for high-grade gliomas than for low-grade gliomas（Z=-3.308,P〈0.01）.The degree of ITSS showed a correlation with the classification of gliomas（r=0.616,P〈0.0001）.Conclusion：SWI call be used as a complementary sequence for gliomas imaging,which offers more complete and detailed information combining with others sequence,SWI may be useful in preoperative grading the brain gliomas at 3.0 T