Bagley L J, Grossman R I, Judy K D, Curtis M, Loevner L A, Polansky M, Detre J
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, USA.
Radiology. 1997 Feb;202(2):511-6. doi: 10.1148/radiology.202.2.9015082.
To determine whether magnetic susceptibility artifact on magnetic resonance (MR) images can be used to grade gliomas.
Twenty-nine patients with gliomas were prospectively examined with spin-echo T1-weighted MR imaging without and with contrast material enhancement, spin-echo or fast spin-echo T2- and proton-density-weighted MR imaging, and gradient-echo T2*-weighted MR imaging. Images were reviewed by two neuroradiologists, and susceptibility artifacts in the tumor region were graded. Heterogeneity, mass effect, contrast enhancement, and necrosis were also graded. Tumors were graded according to the World Health Organization classification.
Increased susceptibility artifact was detected by at least one observer on gradient-echo MR images of 19 tumors. This feature was seen on only 10 of the spin-echo or fast spin-echo T2-weighted MR images of lesions. Fifteen neoplasms with increased susceptibility artifact detected on MR images by at least one observer were high-grade lesions (anaplastic astrocytoma or glioblastoma multiforme). Lesion susceptibility artifact detected on T2*-weighted MR images was associated with tumor grade (P < .05).
Susceptibility artifacts on T2*-weighted gradient-echo MR images appear to be valuable in the preoperative evaluation of gliomas.
确定磁共振（MR）图像上的磁化率伪影是否可用于对胶质瘤进行分级。
对29例胶质瘤患者进行前瞻性检查，采用自旋回波T1加权MR成像（有无对比剂增强）、自旋回波或快速自旋回波T2加权和质子密度加权MR成像以及梯度回波T2*加权MR成像。两名神经放射科医生对图像进行了评估，并对肿瘤区域的磁化率伪影进行了分级。还对异质性、占位效应、对比剂增强和坏死进行了分级。根据世界卫生组织分类对肿瘤进行分级。
至少一名观察者在19个肿瘤的梯度回波MR图像上检测到磁化率伪影增加。在病变的自旋回波或快速自旋回波T2加权MR图像中，只有10个出现了这一特征。至少一名观察者在MR图像上检测到磁化率伪影增加的15个肿瘤为高级别病变（间变性星形细胞瘤或多形性胶质母细胞瘤）。在T2*加权MR图像上检测到的病变磁化率伪影与肿瘤分级相关（P <.05）。
T2*加权梯度回波MR图像上的磁化率伪影在胶质瘤的术前评估中似乎具有重要价值。
