大脑胶质瘤交叉性小脑神经机能联系不能的MR动脉自旋标记灌注成像

目的 采用MR三维动脉自旋标记（3D ASL）灌注成像技术探讨大脑胶质瘤患者交叉性小脑神经机能联系不能（CCD）现象。方法 回顾性分析31名大脑胶质瘤患者和31名正常人的MR资料，采用3D ASL灌注成像技术测量脑组织的脑血流量（CBF），计算并比较患者小脑半球CBF值不对称指数（AI）改变。分析小脑半球AI与大脑半球肿瘤区域AI、肿瘤级别、病变体积的关系。结果 大脑胶质瘤患者肿瘤对侧小脑半球CBF值较同侧小脑半球降低（t=5.04，P<0.01），胶质瘤患者小脑半球AI（AI_小脑）较正常人增高（t=4.13，P<0.01），高级别与低级别胶质瘤间AI_小脑的差异无统计学意义（t=1.31，P>0.05）。患者AI_小脑与大脑肿瘤区域AI（AI_肿瘤：r=-0.28；AI_肿瘤实质：r=-0.24；AI_{肿瘤加水肿}：r=-0.19）、病变体积（r=0.18）均无相关性（P均>0.05）。结论 大脑胶质瘤可出现CCD现象，3D ASL灌注成像可无创定量评估小脑半球低灌注程度，但CCD现象与肿瘤的级别、病变范围及大脑半球AI无明显相关。

MR arterial-spin-labeling perfusion imaging in crossed cerebellar diaschisis in cerebral gliomas

Objective To explore crossed cerebellar diaschisis (CCD) in cerebral gliomas with three-dimensional arterial-spin-labeling (3D ASL) perfusion MRI. Methods The images of 31 patients with cerebral gliomas and 31 normal subjects were retrospectively analyzed. The cerebral blood flow (CBF) were measured with 3D ASL technology, and the asymmetry index (AI) of cerebellar hemispheric CBF value changes were calculated and compared in patients. And the relationship between the AI values of cerebellar hemispheric and the AI values of tumor region in cerebral hemispheric, tumor histological grade and size were investigated. Results Compared with tumor ipsilateral cerebellar hemisphere of supratentorial glioma, the CBF value of contralateral cerebellar hemisphere significantly reduced (t=5.04, P<0.01), and the AI values of cerebellar hemispheric in patients obviously increased compared to normal subjects (t=4.13, P<0.01). But there was no significant difference in the AI values of cerebellum between high grade and low grade gliomas (t=1.31, P>0.05). In cerebral gliomas patients, there was no significant correlation between the AI values of cerebellar hemispheres and the AI values of cerebral hemisphere (tumor:r=-0.28; tumor parenchyma:r=-0.24; tumor plus edema:r=-0.19, all P>0.05), and tumor size (r=0.18, P>0.05). Conclusion Cerebral glioma can cause CCD phenomenon, and 3D ASL is able to quantitatively assess the degree of cerebellar hypoperfusion noninvasively. This phenomenon may not be associated with tumor histological grade, size and the AI values of cerebral hemispheric.