MR动脉自旋标记与动态磁敏感对比增强灌注技术在脑胶质瘤术前评估中的对照研究

目的:对照研究动脉自旋标记(arterial spin labeling,ASL)与动态磁敏感对比增强(dynamic susceptibility contrast-enhanced,DSC)灌注成像技术在脑胶质瘤中的灌注特点,探讨ASL技术在脑胶质瘤术前评估中的应用价值?方法:经病理证实的23例脑胶质瘤患者(包括高级别胶质瘤17例,低级别胶质瘤6例)在术前行3T MRI 的ASL及DSC灌注扫描,测量肿瘤实质部分最大肿瘤血流量(the maximal tumor blood flow,TBFmax)以及对侧白质?灰质和大脑半球的血流量(cerebral blood flow,CBF)?结果:23例脑胶质瘤患者,两种灌注方法均获得了一致的灌注结果,TBFmax/对侧白质CBF?TBFmax/对侧灰质CBF及TBFmax/对侧半球CBF的各比值在ASL和DSC两种技术之间的差异无明显统计学意义(P > 0.05),但在高?低级别胶质瘤之间的差异均有统计学意义(P < 0.05)?结论:ASL在评估脑胶质瘤血流灌注方面与DSC之间有相似的敏感性,具有可重复性高?完全无创性等优点,同时有助于术前对脑胶质瘤进行分级评判?

Comparison of arterial spin labeling and dynamic susceptibility-weighted contrast-enhanced MR imaging in the pre-operation evaluation of brain gliomas

Objective: To compare the arterial spin labeling (ASL) and dynamic susceptibility-weighted contrast-enhanced(DSC)magnetic resonance (MR) imaging and explore the clinical application of ASL technique in the pre-operation of gliomas. Methods: Twenty-three patients with gliomas(all the cases were verified histologically,including 17 patients of high-grade gliomas,6 patients of low-grade gliomas) were routinely examined by 3T MRI including ASL and DSC before operation. The maximal cerebral blood flow of solid regions of tumor (TBFmax) and the cerebral blood flow (CBF) of opposite white matter,grey matter and hemisphere were measured on maps. Results: All of 23 cases demonstrated consistency between ASL and DSC MR imagings. The ratio of TBFmax/opposite white matter CBF,TBFmax/opposite grey matter CBF,TBFmax/opposite hemisphere CBF revealed no statistically significant difference between the two techniques. But there were statistical differences between high-grade and low-grade gliomas. Conclusion: The noninvasive and repeatable ASL technique was almost as sensitive as DSC MRI in detecting brain gliomas perfusing abnormalities. It is helpful to give the gradation of gliomas before operation.