3.0T磁敏感加权成像在颅内胶质瘤中的应用价值

Clinical Application of Susceptibility Weighted Imaging in Cerebral Gliomas

目的探讨3.0T磁敏感加权成像在颅内胶质瘤诊断中的应用价值。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MRI扫描和SWI,15例(10例高级别胶质瘤和5例低级别胶质瘤)于增强前后行SWI。将SWI与常规T_1FLAIR、T_1FLAIR增强图像作比较,并对SWI瘤内低信号形态及数量进行分级评分。结果 SWI较T1FLAIR、T1FLAIR增强图像可更好地确定肿瘤边界,显示瘤内出血、血管结构、瘤周水肿及静脉受压情况。在肿瘤内低信号分级评分中,高级别胶质瘤低信号程度评分明显高于低级别胶质瘤,两组之间的差别有统计学意义(Z=-4.261,P<0.05);胶质瘤级别与肿瘤低信号评分呈正相关(r=0.85,P<0.0001)。结论 3.0 T磁敏感加权成像有助于分析胶质瘤内部的细微结构,有助于胶质瘤分级。

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 and SWI, In 15 cases（ 10 high-grade and 5 low-grade gliomas） ,post-gadolinium enhanced SWI was also obtained. The SWI images were compared with conventional squences including T1 FLAIR,post-contrast T1 FLAIR and the intratumoral susceptibility signals（iTSS） on SWI were graded. Results：SWI was superior to some conventional sequences （ T1 FLAIR, post-contrast T1 FLAIR） in tumor visibility, boundary definition. In the evaluation of blood products, venous vasculature in tumor and vein around tumor SWI appeared better information than all the conventional squences did. Mean grading scores of ITSS in the tumor were higher for high-grade gliomas than for low-grade gliomas （Z = -4. 261, P 〈 0.05 ）. The degree of ITSS showed a significant correlation with the classification of gliomas （ r = O. 85, P 〈 0. 0001 ）. Conclusion ： SWI can 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.