Share：
Share this content in WeChat
X
[Chinese][PDF]99071
• 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.

[1]
Hillen F, Griffioen AW. Tumour vascularization:sprouting angiogenesis and beyond. Cancer Metastasis Rev, 2007, 26(3-4): 489-502.
[2]
Zhang W, Zhao J, Guo D, et al. Application of susceptibility weighted imaging in revealing intratumoral blood products and grading gliomas. J Radiol, 2010, 91(4): 485-490.
[3]
刘传梅，李传亭．磁敏感加权成像在脑肿瘤中的应用进展．医学影像学杂志, 2013, 23(8): 1311-1313.
[4]
陈文锦，林祺，陈金银，等．高分辨率磁敏感加权像对颅内肿瘤微血管的研究．中国医学计算机成像杂志, 2012, 18(4): 294-297.
[5]
林祺，张强，陈东平，等．脑星形细胞瘤磁敏感效应级别与1H-MR波谱相对定量的相关性探讨．磁共振成像, 2012, 3(3): 174-178.
[6]
Park SM, Kim HS, Jahng GH, et al. Combination of high-resolution susceptibility-weighted imaging and the apparent diffusion coefficient: added value to brain tumour imaging and clinical feasibility of non-contrast MRI at 3 T. Br J Radiol, 2010, 83(990): 466-475.
[7]
Pinker K, Noebauer-Huhmann IM, Stavrou I, et al. High-resolution contrast-enhanced, susceptibility-weighted MR imaging at 3T in patients with brain tumors: correlation with positron-emission tomography and histopathologic findings. AJNR, 2007, 28(7): 1280-1286.
[8]
沈俊林，李坤成，杜祥颖，等．磁敏感加权成像技术在脑弥漫性星形细胞瘤分级中的诊断价值．中国现代神经疾病杂志, 2012, 12(6): 675-681.
[9]
ChristoforidisG.A., YangM., AbduljalilA., et al. "Tumoral pseudoblush" identified within gliomas at high-spatialresolution ultrahigh-field-strength gradient-echo MR imaging corresponds to microvascularity at stereotactic biopsy. Radiology, 2012, 264(1): 210-217.
[10]
韩彤，张云亭，刘力，等．星形细胞肿瘤磁敏感加权成像和灌注成像测量指标与肿瘤内微血管密度和血管内皮细胞生长因子的相关性研究．中华放射学杂志, 2013, 47(12): 1086-1091.
[11]
Li C, Ai B, Li Y, et al. Susceptibility-weighted imaging in grading brain astrocytomas. Eur J Radiol, 2010, 75(1): e81-85.
[12]
Zhang H, Tan Y, Wang XC, et al. Susceptibility-weighted imaging:the value in cerebral astrocytomas grading. Neurol India, 2013, 61(4): 389-395.
[13]
沈俊林，张辉，刘起旺，等．磁敏感加权成像对脑肿瘤诊断价值初探．磁共振成像, 2010, 1(1): 29-35.
[14]
Bat DJ, Parisi JE, Kleinschmidt-DeMasters BK, et al. Surgical neuropathology update a review of changes introduced by the WHO classification of tumours of the central nervous system,4thedition. Arch Pathol Lab Med, 2008, 132(6): 993-1007.
[15]
韩彤，崔世民. SWI原理及其在脑肿瘤评估和胶质瘤分级中的应用.国际医学放射学杂志, 2011, 34(1): 15-20.
[16]
Hori M, Mori H, Aoki S, et al. Three-dimensional susceptibility-weighted imaging at 3 T using various image analysis methods in the estimation of grading intracranial gliomas. Magn Reson Imaging, 2010, 28(4): 594-598.
[17]
Cha S, Knopp EA, Johnson G, et al. Intracranial mass lesions:dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology, 2002, 223(1): 11-29.
[18]
Kim HS, Jahng GH, Ryu CW, et al. Added value and diagnostic performance of intratumoral susceptibility signals in the differential diagnosis of solitary enhancing brain lesions:preliminary study. AJNR Am J Neurorad, 2009, 30(8): 1574-1579.
[19]
魏社鹏，赵继中．脑肿瘤卒中的发生机制．国外医学神经病学神经外科学分册, 1999, 26(4): 199-201.
[20]
Arii S, Mori A, Uchida S, et al. Implication of vascular endothelial growth factor in the development and metastasis of human cancers. Hum Cell, 1999, 12(1): 25-30.
[21]
Axelson H, Fredlund E, Ovenberger M, et al. Hypoxia-induced dedifferentiation of tumor cells-A mechanism behind heterogeneity and aggressiveness of solid tumors. Semin Cell Dev Biol, 2005, 16(4-5): 554-563.

PREV MRI features of rosette-forming glioneuronal tumor
NEXT Diffusion tensor imaging study of normal neonatal brain maturation
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn