A Comparative Study Of Semi-quantitative Susceptibility Weighted Imaging With Dynamic Enhanced Perfusion And Pathologic Grading In Gliomas

PurposeTo evaluate the value of high-field susceptibility weighted imaging (SWI) in the grading before surgery and whether there is correlation between intratumoral susceptibility signal intensity (ITSS) and maximum relative cerebral blood volume(rCBV_max).Materials and MethodsThirty-two patients with gliomas received both SWI and DSC examination at 3T MR system. The intratumoral susceptibility signal intensity (ITSS) was graded as 0-3 for semiquantitative analysis. To verify whether there is correlation between ITSS and rCBV_max , the same tumor slice is required. ITSS and rCBV_max were correlated with different histopathologic grades among 3 groups. Spearman correlation analysis was used to determine the correlation between ITSS, rCBV_max, and histopathologic grade. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic accuracy for glioma grading.ResultsOn SWI, the conglomerated mixed fine linear and dot-like ITSSs were demonstrated in all gliomas. These ITSSs were usually located in the inner portion of the contrast-enhancing rim on contrast-enhanced T1-weighted images.Significant difference of ITSSs was found in different pathologic grades of gliomas(P<0.0001,Wilcoxon signed-rank test), Malignant gliomas tended to have a higher ITSS score.There is significant correlation between ITSS and histopathologic grading (r=0.961,p<0.0001).Great difference of rCBV_max was found between low grade gliomas and high grade gliomas. Significant correlation was found between ITSS and rCBV_max (r=0.846, P<0.0001), but densely prominent ITSSs did not correspond with regions of visual rCBV_max. The sensitivity, specificity, positive predictive value, and negative predictive value of ITSS in the grading of gliomas were 94.7%, 84.63%, 90%, and 91.7% respectively.ConclusionsHigh-field SWI is useful in the preoperative assessment of the histopathologic grade of gliomas, and the degree of ITSS shows a significant correlation with the value of rCBV_max in the same tumor sections.