- To explain the main characteristics of SWI sequence. - To asses the role of SWI in the pre-operative grading of brain diffuse gliomas. - To propose a morphological and grading system based on the intratumoral susceptibility signal intensity (ITSS) findings in diffuse gliomas.
Approximately one third of all brain tumors are glial in origin,
the astrocytoma being the most common type and the glioblastoma (GBM) the most common subtype.
Globally they are the most frequent primary brain malignancies as they represent up to 70% of these tumors and their prognostic will strongly depend upon the WHO classification,
grading them from I to IV depending on their malignancy (IV being the most malignant).
More recently new advances in the molecular and genomic field of brain...
Findings and procedure details
We enrolled 45 histologically confirmed diffuse gliomas (WHO 2017 classification).
Forty-one (41) patients with pathology-proven high grade tumors (WHO III-IV) and four (4) low grade gliomas (WHO II).
Seven (7) patients with low grade tumors were ruled out due to previous biopsy/surgery.
All patients underwent a routine pre-operative MRI on a 1.5T scanner using brain coils; SWI was performed in addition to conventional MR sequences,
DSC and DCE perfusion imaging.
Grading gliomas preoperatively,
the combination of SWI and perfusion MRI results in higher sensitivity and specificity. ITSS morphology and grade was useful for the preoperative assessment of the WHO tumor grade. Further investigation must be carried out to determine whether the findings in SWI correlate with the clinical outcome.
Pedro Encinas Resident in training.Department of Radiology,
Hospital Universitario 12 de Octubre,
de Córdoba S/N,
The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary.
Acta Neuropathol (Berl) 2016; 131(6):803-820. Johnson,
(2017). 2016 Updates to the WHO Brain Tumor Classification System: What the Radiologist Needs to Know.
2164–2180. doi:10.1148/rg.2017170037. Sepúlveda-Sánchez,