Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.
Department of Neurosurgery Department, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.
J Clin Neurosci. 2023 Apr;110:92-99. doi: 10.1016/j.jocn.2023.02.012. Epub 2023 Feb 26.
To explore the diagnostic value and feasibility of shear wave elastography and superb microvascular imaging in the grading diagnosis of glioma intraoperatively.
Forty-nine patients with glioma were included in this study. B-mode ultrasonography, Young's modulus in shear-wave elastography (SWE) and vascular architecture in superb microvascular imaging(SMI) of tumor tissue and peritumoral tissue were analyzed. Receiver operating characteristic(ROC) curve analysis was used to evaluate the diagnostic effect of SWE. Logistic regression model was used to calculate the prediction probability of HGG diagnosis.
Compared with LGG, HGG was often characterized by peritumoral edema in B mode (P < 0.05). There was a significant difference in Young's modulus between HGG and LGG; the diagnostic threshold of HGG and LGG was 13.05 kPa, the sensitivity was 78.3%, and the specificity was 76.9%. The vascular architectures of the tumor tissue and peritumoral tissues of HGG and LGG were significantly different (P < 0.05). The vascular architectures of peritumoral tissue in HGG often characterized by distorted blood flow signals surrounding the tumor (14/26,53.8%); in the tumor tissue, HGG often presents as dilated and bent vessels(19/26,73.1%). The elasticity value of SWE and the tumor vascular architectures of SMI were correlated with the diagnosis of HGG.
Intraoperative ultrasound (ioUS), especially SWE, and SMI are beneficial for the differentiation of HGG and LGG and may help optimize clinical surgical procedures.
探讨剪切波弹性成像和超微血管成像在术中胶质瘤分级诊断中的诊断价值和可行性。
本研究纳入 49 例胶质瘤患者。分析肿瘤组织和瘤周组织的灰阶超声、剪切波弹性成像中的杨氏模量（SWE）和超微血管成像中的血管结构。使用受试者工作特征（ROC）曲线分析评价 SWE 的诊断效果。使用逻辑回归模型计算 HGG 诊断的预测概率。
与 LGG 相比，HGG 常表现为瘤周水肿的 B 型模式（P<0.05）。HGG 和 LGG 之间的杨氏模量有显著差异；HGG 和 LGG 的诊断界值为 13.05kPa，敏感度为 78.3%，特异度为 76.9%。HGG 和 LGG 的肿瘤组织和瘤周组织的血管结构有显著差异（P<0.05）。HGG 瘤周组织的血管结构常表现为环绕肿瘤的血流信号扭曲（14/26，53.8%）；在肿瘤组织中，HGG 常表现为扩张和弯曲的血管（19/26，73.1%）。SWE 的弹性值和 SMI 的肿瘤血管结构与 HGG 的诊断相关。
术中超声（ioUS），尤其是 SWE 和 SMI，有助于 HGG 和 LGG 的鉴别，可能有助于优化临床手术方案。
