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Abstract：
Background and objective Susceptibility-weighted imaging (SWI) sequence is crucial for brain MRI examinations, as it is equipped with a high sensitivity to detect calcification, microbleed, and gross hemorrhage. Intracranial venous structures such as the superior sagittal sinus (SSS) and cortical veins are used as reference structures in phase image SWI to differentiate diamagnetic and paramagnetic substances. Our study focuses on the internal cerebral vein (ICV) as another reliable reference structure. We aimed to analyze the diagnostic accuracy and detectability of calcification and hemorrhagic components in brain tumors using ICV, cortical veins, and SSS as references on phase image SWI, with CT scans for comparison. Material and methods A retrospective review of calcification and hemorrhagic components in brain tumors was conducted using MRI and CT from January 2017 to June 2023. Results The study included a total of 192 patients with brain tumors. For calcification components (63 cases), ICV and cortical veins as reference structures showed excellent sensitivity (96.8%), specificity (100%), and accuracy (98.9%). SSS demonstrated slightly lower detectability but maintained high sensitivity (96.5%), specificity (100%), and accuracy (98.8%) levels. No statistical differences were noted among these reference structures (p>0.05) and excellent interobserver agreement (Cohen\'s Kappa of 1) was observed. Conclusions The ICV is located in the central image, is large, without any nearby arteries, and is easy to identify using SWI phase images. Using the ICV as a reference to characterize intratumoral calcification, microbleed, and hemorrhage demonstrates high accuracy and detectability. With its findings of excellent interobserver agreement, our study will be of immense benefit to radiologists.
摘要：
背景与目的磁敏感加权成像(SWI)序列对于脑MRI检查至关重要,因为它具有检测钙化的高灵敏度，微出血,和严重出血。颅内静脉结构，例如上矢状窦（SSS）和皮质静脉被用作相位图像SWI中的参考结构，以区分抗磁性和顺磁性物质。我们的研究重点是大脑内静脉（ICV）作为另一个可靠的参考结构。我们的目的是分析使用ICV的脑肿瘤钙化和出血成分的诊断准确性和可检测性。皮质静脉,和SSS作为相位图像SWI上的参考，用CT扫描进行比较。材料与方法回顾性分析2017年1月至2023年6月采用MRI和CT对脑肿瘤钙化和出血成分进行分析。结果共纳入192例脑肿瘤患者。对于钙化成分（63例），ICV和作为参考结构的皮质静脉表现出优异的敏感性（96.8%），特异性（100%），和准确性（98.9%）。SSS表现出略低的可检测性，但保持高灵敏度（96.5％），特异性（100%），和准确度(98.8%)水平。在这些参考结构之间没有注意到统计学差异(p>0.05),并且观察到极好的观察者间一致性(Cohen的Kappa为1)。结论ICV位于中心图像，很大，附近没有任何动脉，并且易于使用SWI相位图像进行识别。使用ICV作为表征肿瘤内钙化的参考，微出血,出血显示出高准确性和可检测性。凭借其出色的观察员间协议的发现，我们的研究将给放射科医师带来巨大的益处.
