磁敏感加权成像在脑胶质瘤分级中的应用价值

Application value of susceptibility weighted imaging in pathologic grading of brain glioma

目的探讨磁敏感加权成像(susceptibility weighted imaging,SWI)在脑内胶质瘤分级中的价值。方法回顾性分析52个脑内胶质瘤的磁共振常规扫描序列图像及SWI图像表现。结果在21个低级别胶质瘤中,SWI图像上发现2个肿瘤内有出血,常规扫描序列图像上肿瘤内均无出血,且各种图像上肿瘤内均未发现静脉血管影。7个间变型胶质瘤中,SWI图像上发现3个肿瘤内有出血,6个发现静脉血管,常规扫描序列图像上各有1个病灶发现出血及静脉血管。24个胶质母细胞瘤中,SWI图像上均发现有肿瘤内出血及静脉血管,常规扫描序列图像上分别发现9个肿瘤内有出血及4个肿瘤内静脉血管。SWI图像上胶质母细胞瘤内发现出血及静脉血管的肿瘤个数明显多于低级别胶质瘤(出血:Z=-2.154,P=0.031;静脉血管:Z=-6.633,P=0.000),且对胶质母细胞瘤内出血及静脉血管的检出情况,SWI图像明显优于常规扫描序列图像(出血:Z=-3.873,P=0.000;静脉血管:Z=2.236,P=0.025)。结论 SWI发现胶质瘤内微出血及瘤体血供情况明显优于常规扫描序列,且对胶质母细胞瘤与低级别胶质瘤的诊断鉴别具有一定价值。

Objective To investigate the value of susceptibility weighted imaging（SWI） in the pathologic grading of brain glioma.Methods The finding of conventional magnetic resonance sequences and SWI images in 52 cases of brain glioma were retrospectively analyzed.Results In 21 cases of low grade low-grade glioma,there were 2 cases with intratumoral bleeding on SWI images,and there was none with intratumoral bleeding on conventional magnetic reso nance sequences images and no case with intratumoral vein on all images.In 7 cases of anaplastic glioma,there were 3 cases with intratumoral bleeding and 6 cases with vein on SWI images,and there was 1 case with intratumoral bleeding and vein each on conventional magnetic resonance sequences images.In 24 cases of glioblastoma,intratu moral bleeding and vein were found in all glioblastomas on SWI images,and there were 9 cases with intratumoral bleeding and 4 cases with intratumoral vein on conventional magnetic resonance sequences images.Compared to low grade glioma,the cases of glioblastoma with intratumor bleeding and vein were all obviously increased on SWI images（bleeding： Z =-2.154,P = 0.031;vein： Z =-6.633,P = 0.000）,and the finding of intratumor bleeding and vein was obviously better on SWI images than conventional magnetic resonance sequences images（bleeding： Z =-3.873,P = 0.000;vein： Z =-2.236,P = 0.025）.Conclusion SWI is superior to the conventional magnetic resonance sequences in finding intratumoral microhemorrhage and blood supply of tumor and useful for different diagnosis of glioblastoma and low-grade glioma.