ASL在中枢神经系统疾病诊断中的初步应用体会

目的:探讨动脉自旋标记(ASL)MRI灌注成像技术在中枢神经系统疾病中的临床价值.方法:24例颅内病变患者,其中急性脑梗死2例,脑血管畸形7例,胶质瘤4例,淋巴瘤2例,转移瘤4例,脑膜瘤5例.所有病例均经手术病理或随访证实.用ASL技术和动态磁敏感对比成像(DSC)2种方法进行MR灌注成像,分析2种方法对颅内病变的诊断价值.结果:对急性脑梗死患者可以显示灌注缺损区或低灌注区.在评价肿瘤血供方面,ASL与DSC 2种方法所测肿瘤组织rCBF值比较,差异无显著性意义.ASL技术磁敏感伪影明显小于DSC法,对于有出血、钙化的病灶以及颅底病变的显示明显优于DSC法,提高了定量分析的准确性.结论:ASL技术在评价脑组织局部血流灌注方面,具有可重复性高、完全非侵入性、不用注射对比剂等优点.同时对于有出血、钙化或位于颅底的病变,ASL技术明显优于DSC法.

Preliminary Study of Clinical Application of Arterial Spin Labeling in the Diagnosis of Central Nervous System Diseases

Objective:To investigate the preliminary application of arterial spin labeling (ASL) of MRI perfusion technique in the clinical diagnosis of central nervous system diseases.Methods:ASL and dynamic susceptive contrast (DSC) were performed in 24 patients with acute stroke (n=2),cerebral vascular anomaly (n=7),glioma (n=4),cerebral lymphoma (n=2),cerebral metastases (n=4),meningioma (n=5).All of the cases were proved by surgery or clinical follow-up,Diagnostic value of the two methods was evaluated. Results:ASL displayed the regions with low or deficient perfusion in acute stroke.For the evaluation of blood supply of tumor,ASL and DSC had no significatly statistical difference.ASL was superior to DSC in the demonstration of cerebral hemorrhage,calcification and skull base lesions due to the less magnetic susceptive artifact in ASL,which improved the accuracy of quantitative analysis.Conclusion:For the evaluation of focal perfusion of brain,ASL showed advantages as follows:noninvasive technique,not necessary to use contrast agents,high repea-tability.Meanwhile,ASL is superior to DSC in the demonstration of cerebral hemorrhage,calcification and disease in located at the skull base.