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• Clinical Article •
SWI study on astrocytoma grading and differential diagnosis of astrocytoma and solitary metastases
WANG Wei-wei  NIU Tian-li  MIAO Yan-wei  SONG Qing-wei  WEI Qiang  HE Zhen-fei  LIU Ai-lian 

DOI:10.3969/j.issn.1674-8034.2015.04.002.


[Abstract] Objective: The purpose of this study is to explore the value of the intratumoral susceptibility signal intensity (ITSS) in grading of astrocytoma and in differential diagnosis of astrocytomas and metastases.Materials and Methods: Forty-two recruited patients with brain tumors confirmed pathologically, including 14 solitary metastases and 28 astrocytomas(WHO grade Ⅰ=3, grade Ⅱ=8, grade Ⅲ=9 and grade Ⅳ=8) underwent conventional MRI examinations and susceptibility weighted imaging (SWI). Intratumoral susceptibility signal intensity(ITSS)in tumor parenchyma was obtained. The ITSS values were further compared between different grades of astrocytoma and between astrocytomas and metastases by Wilcoxon test. Receiver operating characteristic curve (ROC) was used to determine the differentiation ability of ITSS number for astrocytoma grading and brain tumors differential diagnosis. Spearman coefficient correlation analysis was used to analyze the relation between ITSS and astrocytoma grade.Results: The mean values of ITSS in grade Ⅰ, Ⅱ, Ⅲ, Ⅳ astrocytomas and metastases were respectively (3.0±2.67), (4.12±0.64), (18.11±2.15), (18.75±2.48) and (6.14±1.56). Significant difference was observed in high-grade (Ⅲ and Ⅳ) and low-grade (Ⅰ and Ⅱ) astrocytomas (H=13.156, P<0.01), and even between the grades Ⅱ and Ⅲ astrocytomas (H=7.835, P<0.01), while no significant difference was found between grade Ⅲ and Ⅳ astrocytomas(H=0.021, P=0.885). Positive correlation was observed between ITSS and astrocytoma grade (r=0.746, P=0.000). Area under the ROC curve (AUC) was 0.912 in differentiation of the high-grade and low-grade astrocytomas when the cutoff value was set as 7.5, and the sensitivity and specificity were 88.2% and 81.8%. AUC was 0.903 in differentiation of the grade Ⅱ and grade Ⅲ astrocytomas when the cutoff value was set as 6.0, and the sensitivity and specificity were 100% and 87.5%. Significant differences of ITSS were observed between the metastases (mean rank=9.89) and high-grade astrocytomas(mean rank=21.06) (H=11.679, P=0.001), while no significant difference was observed between the metastases and low-grade astrocytomas. AUC in differentiation of the high-grade astrocytomas and metastases was 0.861 when the cutoff value of ITSS was set as 6.5, and the sensitivity and specificity were 94.1% and 71.4%.Conclusion: ITSS is helpful to determine the grade of astrocytoma and differentiate the high grade astrocytoma and metastates, which reflects the microhemorrhage and tumor vessels in the tumor parenchyma.
[Keywords] Astrocytoma；Brain neoplasms；Neoplasm metastasis；Magnetic resonance imaging

WANG Wei-wei Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

NIU Tian-li Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

MIAO Yan-wei* Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

SONG Qing-wei Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

WEI Qiang Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

HE Zhen-fei Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

LIU Ai-lian Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

*Correspondence to: Miao YW, E-mail: ywmiao716@163.com

Conflicts of interest   None.

Received  2015-01-26
Accepted  2015-03-03
DOI: 10.3969/j.issn.1674-8034.2015.04.002
DOI:10.3969/j.issn.1674-8034.2015.04.002.

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