mTI-ASL技术在鉴别脑胶质瘤术后复发与放射性损伤中的应用价值

目的应用多反转时间动脉自旋标记(multiple inversion time-pulsed arterial spin labeling,mTI-ASL)技术,定量分析脑胶质瘤术后复发与放射性损伤的不同,进一步评估该技术对两者的鉴别诊断价值。材料与方法使用西门子公司3.0 T Skyra扫描仪,收集2017年1月到2018年12月在内蒙古医科大学附属医院就诊的脑胶质瘤术后放疗后MR增强扫描出现异常强化灶的患者,并经手术后病理及临床随访证实脑胶质瘤二次复发20例,放射性损伤10例,行mTI-ASL序列扫描。mTI-ASL原始图像通过MATLAB软件进行后处理,得到脑血流量(cerebral blood flow,CBF)图和动脉通过时间(arterial transit time,ATT)图,应用MRIcron软件手动勾画感兴趣区,测量术后异常强化区的定量CBF值和ATT值。分别采用独立样本t检验比较脑胶质瘤术后复发与放射性损伤感兴趣区相关参数值,评价定量参数CBF值和ATT值的差异,从而评估mTI-ASL技术对二者的鉴别诊断能力。结果(1)对比脑胶质瘤术后复发与放射性损伤CBF值,脑胶质瘤术后复发CBF值(6.38±1.41),比放射性损伤CBF值(2.30±0.37)高,两者比较具有统计学意义(P<0.01);(2)对比脑胶质瘤术后复发与放射性损伤ATT值,脑胶质瘤术后复发ATT值(0.19±0.30),比放射性损伤CBF值(0.16±0.12)高,两者比较具有统计学意义(P<0.01)。结论mTI-ASL技术中定量CBF及ATT值可以对高级别脑胶质瘤术后复发与放射性损伤进行鉴别。

Application of m TI-ASL technique in differentiating recurrence from radiation injury of brain glioma after operation

Objective:In this study,we use multiple inversion time-pulsed arterial spin labeling(mTI-ASL)technique to quantitatively analyze the difference between recurrence and radiation injury of glioma after operation,to further evaluate the value of mTI-ASL technique in differential diagnosis between recurrence and radiation injury of glioma.Materials and Methods:In this study,20 cases of glioma recurrence,10 cases of radiation injury subjects were collected.We used Siemens 3.0 T Skyra scanner to collect,mTI-ASL sequence was performed on a 3.0 T MR scanner(Magnetom Skyra,Siemens Healthcare,Erlangen,Germany)after surgery and radiotherapy in patients with glioma.The original image of mTI-ASL was post processed on MATLAB software to obtain CBF and ATT maps.The region of interest was delineated manually by using MRI cron soft ware.Independent sample t-test was used to compare the parameters of the region of interest(ROI)related to recurrence and radiation injury of glioma after operation,and to evaluate the difference of CBF and ATT values of quantitative parameters,so as to evaluate the ability of mTI-ASL technology to differentiate the two parameters.Results:(1)CBF values of recurrence after glioma surgery(6.38±1.41)were higher than those of radiation injury(2.30±0.37).There was significant difference between them(P<0.01).(2)ATT values of recurrence after glioma surgery(0.19±0.30)were higher than the CBF values of radiation injury(0.16±0.12),and the difference was statistically significant(P<0.01).Conclusions:The mTI-ASL technique can distinguish the recurrence and radiation injury of glioma after operation.