磁敏感加权成像显示肿瘤内静脉评价胶质瘤分级

目的 应用磁敏感加权成像（SWI）检测胶质瘤瘤内静脉,探讨SWI显示瘤内静脉对胶质瘤分级的价值.方法 经手术病理证实的胶质瘤患者39例,包括低级别胶质瘤18例（WHOⅠ～Ⅱ级）、高级别胶质瘤21例（WHOⅢ～Ⅳ级）.所有患者均在GE 3.0T MRI成像系统下行基本和SWI序列扫描,图像在GE ADW 4.2工作站经最小密度投影重建获得SWI图像,逐层观察SWI图像上胶质瘤瘤内静脉的分布情况,并按静脉数量进行评分,分析其统计学差异,然后对瘤内静脉评分与肿瘤级别行相关性分析.结果 在SWI图像上,低级别胶质瘤组静脉检出率为28％,高级别胶质瘤组静脉检出率为100％,二者差异有统计学意义（χ^2=22.750,P＜0.01）;低级别胶质瘤组静脉评分：0分13例（72％）、1分5例（28％）;高级别胶质瘤组静脉评分：1分4例（19％）、2分17例（81％）,二者静脉评分差异有统计学意义（Z=-5.411,P＜0.01）;瘤内静脉评分与胶质瘤病理级别呈正相关（r=0.878,P＜0.01）.结论 SWI显示瘤内静脉对胶质瘤分级有辅助意义.

Values of tumor vein detected by susceptibility weighted imaging in evaluation of gliomas grade

Objective To study the value of tumor vein detected by susceptibility weighted imaging （SWI） in evaluation of glioma grade.Methods Thirty-nine cases of gliomas were confirmed pathologically,including 18 cases of low-grade gliomas （WHO Ⅰ-Ⅱ grade） and 21 cases of high-grade gliomas （WHO Ⅲ-Ⅳ grade）.All cases were underwent routine MR series and SWI scanning,and SWI images were obtained with minimum intensity projection on GE ADW 4.2 work-station.SWI images were observed,and veins within glioma were scored to analyze its statistical difference,and the correlation between tumor vein scores and glioma grade was also analyzed.Results On SWI,tumor vein detection rate was 28％ in low-grade gliomas group,and 100％ in high-grade gliomas group,the difference was statistically significant （χ^2=22.750,P＜0.01）; Among the 18 cases of low-grade gliomas,the tumor vein score was 0 point in 13 cases（72％） and 1 point in 5 cases（28％）,while it was 1 piont in 4 cases（19％） and 2 point in 17 cases （81％） among the 21 cases of high-grade gliomas.There was significant difference between two gliomas（Z=-5.411,P＜0.01）; The tumor vein score was positively correlated with the pathological grade （r=0.878,P＜0.01）.Conclusion SWI had remarkable auxiliary benefit in grading ofglioma by observing intratumoral veins.