摘要
目的探讨磁敏感加权成像（SWI）在颅脑神经上皮肿瘤术前分级中的诊断价值。方法分析7l例经手术病理证实的颅脑神经上皮肿瘤患者的MRI资料，其中，33例WHOI～Ⅱ级为低级别组，38例WHOⅢ～Ⅳ级为高级别组。所有患者的常规扫描（平扫＋增强）及SWI均在3．0T超导MRI下完成。在SWI上所有图像中对各肿瘤内部情况（肿瘤实质的信号、肿瘤静脉分布情况、肿瘤内的出血情况及肿瘤内部静脉血管数量）进行分析，利用手工逐层勾勒出肿瘤显示的出血成分面积，计算每例患者SWI所显示的肿瘤内出血的总体积（单位：cm-3）。结果（1）SWI上显示肿瘤的实质信号（高信号、等信号及稍低信号）在高、低级别神经上皮肿瘤鉴别诊断中差异有统计学意义（P〈0．001）；（2）高、低级别神经上皮肿瘤内静脉分布情况（稀疏、密集）差异有统计学意义（P〈0．001）；（3）高、低级别神经上皮肿瘤的出血率差异有统计学意义（P〈0．05）；（4）高、低级别神经上皮肿瘤的出血量及瘤内血管数差异有统计学意义（P〈0．001）；（5）神经上皮肿瘤瘤内小血管数与出血量、瘤内小血管数目与神经上皮肿瘤的级别、瘤内出血量与神经上皮肿瘤的级别均呈正相关（P〈0．001）。结论SWI通过对肿瘤的实质信号特点、瘤内静脉分布特点、瘤内血管数量及瘤内出血量的分析，可为术前脑神经上皮肿瘤的正确分级提供更多的信息。
Objective To evaluate the diagnostic value of susceptibility weighted imaging （SWI） in the grading of cer- ebral neuroepithelial tumors. Methods Seventy one patients with cerebral neuroepithelial tumors confirmed by pathology received routine MR sequences and SWI examination on 3.0T scanner（ SigMa Excite HD 3.0T）. The patients were divided into low grade group（WHO I～Ⅱ grade,33 cases） and high grade group（WHO Ⅲ～Ⅳ grade,38 cases）. SWI including phase images and magnitude images were obtained by using the SWI postprocessing software of the MR system and created a minimum intensity projection settings （MinPs）. The signal intensity, distribution of venous structures and bleeding condi- tion of the tumors were observed respectively on SWI. The blood products detected by SWI were measured in each slice and the total hemorrhage volume （cm3） within the tumors were calculated. The number of small vessels and the sectional vol- ume of hemorrhage were compared between two groups of cerebral neural epithelial tumors. Results （ 1 ） There was statis- tical significance of signal intensity between low grade and high grade groups（ P 〈 0. 001 ）. （2）There was statistical signifi- cance of venous structures distribution between 2 groups（ P 〈 0. 001 ）. （ 3 ） There was statistical significance of bleeding inci- dence between 2 groups （P 〈 0.05 ）. （4）There were statistical significances of volume of blood products and the number of small vessels detected on SWI between 2 groups. Low grade tumors had less hemorrhage and small vessels（ P 〈 0. 001 ）. （5） The hemorrhage volume had positive correlation with the number of small vessels, both two index showed positive corre- lation with the tumor grading （ P 〈 0. 001 ）. Conclusion SWI may offer more information for cerebral neuroepithelial tumor grading in clinical practice, by analyzing the signal intensity of tumor, distribution of venous structures, the hemor-rhage volume and the number of the small vessels.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第10期1388-1393,共6页
Journal of Clinical Radiology
关键词
磁敏感加权成像
颅脑神经上皮肿瘤
出血
分级
Susceptibility weighted imaging Cerebral neuroepithelial tumor Hemorrhage Grading
