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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71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3.0 T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:cm3)。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 investigate the diagnostic value of magnetic resonance weighted imaging (SWI) in preoperative classification of cranial neuroepithelial neoplasms. Methods MRI data of 71 patients with surgically and pathologically confirmed cranial neuroepithelial neoplasia were analyzed. Among them, 33 cases were classified as low-grade WHOⅠ-Ⅱ and 38 cases WHOⅢ-Ⅳ were classified as high-grade. All patients underwent conventional scanning (scan + enhancement) and SWI in 3.0 T superconducting MRI. In all the images on the SWI, the internal conditions of the tumors (the signal of the tumor, the distribution of the tumor veins, the bleeding in the tumor and the number of the internal venous blood vessels in the tumor) were analyzed, and the area of bleeding components displayed by the tumor was sketched by hand, The total volume of intratumoral hemorrhage (unit: cm3) displayed by each patient’s SWI was calculated. Results (1) The real signals of tumors (high signal, equal signal and slightly lower signal) on SWI showed significant difference in high and low grade neuroepithelial tumors (P <0.001); (2) High and low (P <0.001). (3) There was significant difference in hemorrhage rate between high and low grade neuroepithelial tumors (P <0.05); (4) (P <0.001). (5) The number of small blood vessels and the amount of bleeding, the number of small blood vessels and the number of neuroepithelial neoplasms in neuroepithelial neoplasms were significantly higher than those in low-grade neuroepithelial tumors Tumor grade, intratumoral hemorrhage and neuroepithelial tumor grade were positively correlated (P <0.001). Conclusion SWI can provide more information on the correct classification of preoperative neuroepithelial neoplasms by analyzing the characteristics of the tumor signal, the characteristics of the intratumoral veins, the amount of intratumoral blood vessels and the amount of intratumoral hemorrhage.