|ECR 2019 / C-2576|
|Susceptibility-weighted imaging: every dot and line counts for diffuse glioma grading|
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. Intratumoral susceptibility signal intensity (ITSS) was classified on the basis of morphology (dots, linear structures or mixed) and grade (grade 0 = no ITSS; grade I =1-5 dotlike or fine linear ITSS; grade II = 6-10 and grade III >11).
Univariate analysis was performed with Xi square test.
75% of low-grade tumors showed no ITSS on SWI, and the presence of microbleeds was independent of astrocytic or oligodendrocytic origin.
The degree of ITSS of grade III gliomas was lower than in grade IV tumors (p<0.05). Regarding ITSS, anaplastic gliomas showed more frequently (66.7%) a grade O and glioblastomas a grade III (67.6%).
Contrast enhancement was also related to ITSS. 80% of non-enhancing tumors showed a grade O and 68.6% of enhancing tumors showed a grade III.
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