三维动脉自旋标记法在胶质瘤术前的应用价值

目的探讨三维动脉自旋标记法（3D-ASL）在脑胶质瘤术前分级的应用价值。方法选择45例经病理证实的胶质瘤患者（高级别26例,低级别19例）,行常规MRI及3D-ASL检查,于脑血流量图测量肿瘤实性部分灌注最明显区及健侧CBF值,计算TBFmax/CBF健侧比值;观察全脑灌注情况。结果 45例均获得高质量全脑灌注图。高级别胶质瘤于脑血流量图上显示不同程度高灌注,低级别胶质瘤灌注正常或减低,高低级别胶质瘤TBFmax/健侧比值分别为3.11±1.45、0.86±0.28,其差异有统计学意义（P﹤0.01）。9例高级别胶质瘤出现瘤体周围血管较健侧扩张,CBF值升高征象。结论 3D-ASL可在术前安全无创地提取胶质瘤灌注信息以判断其级别,并且可评估患者全脑血流量情况,有助于术前制定周密方案。

Application value of three dimensional arterial spin labeling method in preoperative glioma

Objective To investigate the application value of three-dimensional arterial spin labeling in the preoperative glioma.Methods 45 patients with glioma proved by pathology（26cases of high grade and 19 cases of low）were setected and underwent the conventional MRI and 3D-ASL examination.We measured CBF value in the cerebral blood flow diagram,one was on the most obvious perfusion area of the solid part of tumors and another on the contralateral area.Then TBFmax/CBF contralateral ratio was calculated.We also observed the whole brain perfusion.Results We found that 45 cases were gained high quality whole brain perfusion maps.High grade gliomas in cerebral blood flow map were shown different degrees of highperfusion,low grade gliomas were presented with perfusion of normal or reduced.TBFmax/contralateral ratios in the high and low grade gliomas were 3.11±1.45 and 0.86±0.28,with significant difference between the two groups（P〈0.01）.9cases of high grade gliomas appeared expansion vascular around the tumor,and the CBF value was risen.Conclusion We thought 3D-ASL could gain glioma perfusion information to determine the grade before preoperation and it was safe and noninvasive.And it could estimate the whole brain perfusion to help for formulating preoperative careful plan.