Xu Jianxing, Xu Hai, Zhang Wei, Zheng Jiangang
Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, Changzhou, Jiangsu 213002, P.R. China.
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 213002, P.R. China.
Exp Ther Med. 2018 Jun;15(6):5113-5118. doi: 10.3892/etm.2018.6017. Epub 2018 Apr 2.
The aim of the present study was to assess the value of susceptibility-weighted imaging (SWI) and diffusion-weighted imaging (DWI) in the grading of gliomas and to evaluate the correlation between these quantitative parameters derived from SWI and DWI. A total of 49 patients with glioma were assessed by DWI and SWI. The evaluation included the ratio of apparent diffuse coefficient values between the solid portion of tumors and contralateral normal white matter (rADC) and the degree of intratumoral susceptibility signal intensity (ITSS) within tumors. Receiver operating characteristic curve (ROC) analyses were performed and the area under the ROC curve was calculated to compare the diagnostic performance, determine optimum thresholds for tumor grading, and calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for identifying high-grade gliomas. The correlation between DWI- and SWI-derived parameters was also evaluated. The rADC and the degrees of ITSS within tumors were significantly higher in high-grade gliomas than those in low-grade gliomas. ROC curve analysis indicated that the rADC was a better index for grading gliomas than the ITSS degree. Statistical analysis demonstrated a threshold value of 1.497 for rADC to provide a sensitivity, specificity, PPV and NPV of 86.2, 85.0, 89.3 and 81.0%, respectively, for determining high-grade gliomas. A degree of ITSS of 1.5 was defined as the threshold to identify high-grade gliomas and sensitivity, specificity, PPV and NPV of 82.8, 75.0, 82.8 and 75.0% were obtained, respectively. Furthermore, a moderate inverse correlation between rADC and the ITSS degree was revealed. Combination of SWI with DWI may provide valuable information for glioma grading.
本研究的目的是评估磁敏感加权成像（SWI）和弥散加权成像（DWI）在胶质瘤分级中的价值，并评估从SWI和DWI得出的这些定量参数之间的相关性。共有49例胶质瘤患者接受了DWI和SWI评估。评估内容包括肿瘤实性部分与对侧正常白质之间的表观扩散系数值之比（rADC）以及肿瘤内肿瘤磁敏感信号强度（ITSS）程度。进行了受试者操作特征曲线（ROC）分析，并计算了ROC曲线下面积，以比较诊断性能、确定肿瘤分级的最佳阈值，并计算识别高级别胶质瘤的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。还评估了DWI和SWI衍生参数之间的相关性。高级别胶质瘤内的rADC和ITSS程度显著高于低级别胶质瘤。ROC曲线分析表明，rADC在胶质瘤分级方面比ITSS程度是更好的指标。统计分析表明，rADC的阈值为1.497时，对于确定高级别胶质瘤的敏感性、特异性、PPV和NPV分别为86.2%、85.0%、89.3%和81.0%。将ITSS程度1.5定义为识别高级别胶质瘤的阈值，敏感性、特异性、PPV和NPV分别为82.8%、75.0%、82.8%和75.0%。此外，还揭示了rADC与ITSS程度之间存在中度负相关。SWI与DWI联合应用可能为胶质瘤分级提供有价值的信息。
