脑胶质瘤的磁共振磁敏感加权成像研究进展。
An update on susceptibility-weighted imaging in brain gliomas.
作者信息
Martín-Noguerol Teodoro, Santos-Armentia Eloísa, Ramos Ana, Luna Antonio
机构信息
MRI Unit, Radiology Department, HT Medica, Carmelo Torres 2, 23007, Jaén, Spain.
Department of Radiology, Povisa Hospital (Ribera Salud Group), Vigo, Spain.
出版信息
Eur Radiol. 2024 Oct;34(10):6763-6775. doi: 10.1007/s00330-024-10703-w. Epub 2024 Apr 6.
Susceptibility-weighted imaging (SWI) has become a standard component of most brain MRI protocols. While traditionally used for detecting and characterising brain hemorrhages typically associated with stroke or trauma, SWI has also shown promising results in glioma assessment. Numerous studies have highlighted SWI's role in differentiating gliomas from other brain lesions, such as primary central nervous system lymphomas or metastases. Additionally, SWI aids radiologists in non-invasively grading gliomas and predicting their phenotypic profiles. Various researchers have suggested incorporating SWI as an adjunct sequence for predicting treatment response and for post-treatment monitoring. A significant focus of these studies is on the detection of intratumoural susceptibility signals (ITSSs) in gliomas, which are indicative of microhemorrhages and vessels within the tumour. The quantity, distribution, and characteristics of these ITSSs can provide radiologists with more precise information for evaluating and characterising gliomas. Furthermore, the potential benefits and added value of performing SWI after the administration of gadolinium-based contrast agents (GBCAs) have been explored. This review offers a comprehensive, educational, and practical overview of the potential applications and future directions of SWI in the context of glioma assessment. CLINICAL RELEVANCE STATEMENT: SWI has proven effective in evaluating gliomas, especially through assessing intratumoural susceptibility signal changes, and is becoming a promising, easily integrated tool in MRI protocols for both pre- and post-treatment assessments. KEY POINTS: • Susceptibility-weighted imaging is the most sensitive sequence for detecting blood and calcium inside brain lesions. • This sequence, acquired with and without gadolinium, helps with glioma diagnosis, characterisation, and grading through the detection of intratumoural susceptibility signals. • There are ongoing challenges that must be faced to clarify the role of susceptibility-weighted imaging for glioma assessment.
磁敏感加权成像(SWI)已成为大多数脑部 MRI 方案的标准组成部分。虽然传统上用于检测和表征通常与中风或外伤相关的脑部出血,但 SWI 在评估胶质瘤方面也显示出有希望的结果。许多研究强调了 SWI 在区分胶质瘤与其他脑部病变(如原发性中枢神经系统淋巴瘤或转移瘤)方面的作用。此外,SWI 有助于放射科医生对胶质瘤进行非侵入性分级,并预测其表型特征。许多研究人员建议将 SWI 作为预测治疗反应和治疗后监测的辅助序列。这些研究的一个重要重点是检测胶质瘤中的肿瘤内磁化率信号(ITSS),这些信号表明肿瘤内存在微出血和血管。这些 ITSS 的数量、分布和特征可为放射科医生提供更精确的信息,以评估和表征胶质瘤。此外,还探讨了在使用钆基对比剂(GBCA)后进行 SWI 的潜在益处和附加值。本综述全面、教育性地介绍了 SWI 在胶质瘤评估中的潜在应用和未来方向。临床相关性声明:SWI 已被证明在评估胶质瘤方面非常有效,特别是通过评估肿瘤内磁化率信号变化,并且正在成为 MRI 方案中一种有前途、易于整合的工具,可用于治疗前和治疗后的评估。关键点:• 磁敏感加权成像(SWI)是检测脑部病变内血液和钙的最敏感序列。• 这个序列,结合有无钆剂,通过检测肿瘤内磁化率信号,有助于胶质瘤的诊断、特征和分级。• 为了阐明 SWI 在胶质瘤评估中的作用,目前仍存在一些必须面对的挑战。
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