高场磁共振三维准连续动脉自旋标记序列对头颈部肿瘤非对比剂增强灌注成像  

Three-dimensional Pseudo-continuous Arterial Spin Label Non-contrast Enhanced Perfusion Imaging of Head and Neck Tumors with High-field MR System

作　　者：陈钰[1] 段淼[1] 周海龙[1] 史凯宁 孙照勇[1] 白春梅[3] 贾宁[3] 张韬[4] 陈兴明[5] 胡克[6] 张竹花[1] 金征宇[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730 [2]GE医疗集团MR应用科学实验室,北京100176 [3]中国医学科学院北京协和医学院北京协和医院肿瘤化疗科,北京100730 [4]中国医学科学院北京协和医学院北京协和医院口腔科,北京100730 [5]中国医学科学院北京协和医学院北京协和医院耳鼻喉科,北京100730 [6]中国医学科学院北京协和医学院北京协和医院放疗科,北京100730

出　　处：《中国医学科学院学报》2015年第5期567-574,共8页Acta Academiae Medicinae Sinicae

基　　金：卫生公益性行业科研专项项目(201402019)~~

摘　　要：目的研究高场磁共振三维准连续动脉自旋标记(3D p CASL)序列对头颈部肿瘤非对比剂增强灌注成像的可行性,分析不同标记时间(PLD)对图像质量的影响及肿瘤血流量重复测量的信度。方法前瞻性分析2013年6月至9月在北京协和医院临床发现头颈部肿瘤但未经过治疗的患者25例,所有患者均行头颈部3D p CASL非对比剂增强灌注扫描。在进行常规T1加权及T2加权成像后,进行3组不同标记后延迟(PLD)时间的ASL序列扫描:ASL1(PLD1=1525 ms)、ASL2(PLD2=2025 ms)和ASL3(PLD3=2525 ms)。测量3组ASL灌注加权图像上肿瘤区域及背景的信号强度(SI),计算肿瘤区域的信噪比(SNR)及对比噪声比(CNR)。由两位观察者分别对3D p CASL的灌注加权图像上螺旋伪影及颈部血管伪影的显示情况进行评分,测量血流量(BF)图像上肿瘤区域的BF值。结果共对17例取得病理结果的患者进行3D p CASL的图像质量评价及肿瘤的BF值测量。ASL1、ASL2及ASL3的SNR及CNR均依次降低,其中ASL1与ASL3的SNR(P=0.011)及CNR(P=0.009)差异有统计学意义。3组ASL螺旋伪影评分差异无统计学意义(P=0.932)。ASL1、ASL2及ASL3灌注加权图像颈部血管伪影的定性评分均值依次减低,其中ASL1与ASL3的差异有统计学意义(P=0.000)。3组BF值的观察者间及观察者内重复测量的信度水平均非常好(ICC>0.9)。尽管ASL1、ASL2及ASL3序列的BF均值依次升高,但差异无统计学意义(P=0.977)。结论采用3D p CASL高场磁共振进行头颈部肿瘤非对比剂增强灌注成像可以获得比较满意的图像质量,并且肿瘤BF值具有较好的重复测量信度。在3组3D p CASL序列中,PLD=1525 ms及PLD=2025 ms序列的图像质量优于PLD=2525 ms序列,且BF值无明显差异,因此更适合头颈部肿瘤3D p CASL灌注成像。Objective To evaluate the feasibility of three-dimensional pseudo-continuous arterial spin label（ 3D pCASL） non-contrast enhanced perfusion imaging applied to head and neck tumors in high-field MR and detect the effects of different postlabeling delay（ PLD） time on image quality and the reliability of repeated measurements of tumor blood flow（ BF） in different 3D pCASL groups. Methods In this prospective study,all the 25 patients received neck 3D pCASL non-contrast enhanced perfusion examinations in a 3. 0 T MR system by using an 8-channel head and neck joint coil. Conventional T1-weighted（ TIWI） and T2-weighted imaging（ T2WI） were performed firstly. Finally,three 3D pCASL with different PLD time [ASL1（ PLD1= 1525 ms）,ASL2（ PLD2= 2025 ms）,ASL3（ PLD3= 2525 ms） ] were acquired. Patients＇ perfusion-weighted images acquired from different 3D pCASL sequences underwent the analysis of signal to noise ratio（ SNR） and contrast noise ratio（ CNR） for tumors. Two observers performed the qualitative assessments on spiral artifacts and vascular artifacts of perfusion-weighted images from different 3D pCASL sequences. Blood flow（ BF） of tumors from different 3D pCASL sequences were measured by the two observers respectively for the first time and by observer2 for the second time. Results Seventeen enrolled patients（ age： 50. 1 ± 12. 7 years,M / F = 10 ∶7） with histopathologic results underwent the evaluation of image quality and measurements of BF values. The SNRs and CNRs of ASL1, ASL2, and ASL3 showed a descending trendency. SNRs（ P = 0. 011） and CNRs（ P =0. 009） of ASL1 were significant higher than those of ASL3. There was no significant difference of scores of spiral artifacts among the three ASL groups（ P = 0. 932）. The scores of vascular artifacts of ASL1,ASL2,and ASL3 showed a descending trendency, also. And scores of ASL1 was significant higher than that of ASL3（ P =0. 000）. The intraclass correlation coefficient（ ICC） of intre-and intraobserver

关 键 词：动脉自旋标记 图像质量 血流量 信度分析 头颈部肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]