常规行3D-ASL检查对颅脑病变诊断的初步探讨  

A Preliminary Study on the Diagnosis of Craniocerebral Lesions by Routine 3d-asl Examination

作　　者：王伟[1] 徐伟[1] 孟凡然 冯会玉 徐涛 吴晓静 WANG Wei;XU Wei;MENG Fan-ran;FENG Hui-yu;XU Tao;WU Xiao-jing(Department of Medical Imaging,Zhuozhou Hospital,Baoding,Heibei 072750)

机构地区：[1]河北省涿州市医院医学影像科,河北保定072750

出　　处：《智慧健康》2021年第4期10-12,21,共4页Smart Healthcare

摘　　要：目的常规应用3.0T 磁共振三维动脉自旋标记(ASL)技术在颅脑病变诊断中的初步应用。方法回顾分析我院60例患者常规颅脑MRI检查时,加扫ASL检查病例,重建灌注图像,分析CBF参数,结合常规MRI图像,判断病变情况,对常规和后处理图像,进行定性和定量分析病变区域。结果共计60例在常规颅脑MRI检查同时行3D-ASL灌注成像,其中2例体检患者局部脑组织灌注减低;25例脑血管病患者显示相应区域明显低灌注区;9例肿瘤性病变,1例低级别胶质瘤显示肿瘤病变呈低灌注,3例高级别胶质瘤显示肿瘤范围高灌注征像;2例来自肺癌转移瘤病变,ASL-rCBF显示病变区域灌注均明显增加;2例淋巴瘤病变,显示病变区域呈明显低灌注征像;1例脑膜瘤病变,显示病变区域呈明显高灌注征像。结论 3D-ASL技术能快速非侵袭性地提供脑血流灌注信息,对缺血性脑血管病提供更加准确的诊断;对各种肿瘤性病变,除可用于评估其血供情况外,结合常规检查,有助于对肿瘤性病变的诊断和鉴别诊断。在可疑脑缺血和肿瘤性病变、行MRI检查时,增加ASL灌注成像,可提供局部血供信息。Objective To apply 3.0T magnetic resonance 3D arterial spin marker (ASL) in the diagnosis of craniocerebral lesions.Methods Retrospective analysis of 60 cases of patients in our hospital during routine craniocerebral MRI examination,scanning of ASL cases,reconstruction of perfusion images,analysis of CBF parameters,combined with conventional MRI images,diagnosis of lesion status,and qualitative and quantitative analysis of lesion areas by routine and post-processing images.Results A total of 60cases received 3D-ASL perfusion imaging at the same time on routine cranial MRI examination,among which 2 patients underwent reduced local cerebral tissue perfusion in physical examination.The 25 patients with ischemic cerebrovascular disease showed obvious low perfusion area in corresponding areas.In 9 cases of neoplastic lesions,1 case of low-grade glioma showed low perfusion,and 3 cases of high-grade glioma showed high perfusion in tumor range.In the 2 patients with metastatic lung cancer,asl-rCBF showed significantly increased perfusion in the lesion area.Two cases of lymphoma showed obvious hypoperfusion in the lesion area.One case of meningioma showed a prominent hyperperfusion pattern in the lesion area.Conclusion 3D-asl technology can provide cerebral blood perfusion information rapidly and noninvasively,and provide more accurate diagnosis for ischemic cerebrovascular disease.For all kinds of neoplastic lesions,in addition to evaluating their blood supply,combined with routine examination,it is helpful for the diagnosis and differential diagnosis of neoplastic lesions.When MRI was performed on suspected cerebral ischemia and neoplastic lesions,ASL perfusion imaging was added to provide local blood supply information.

关 键 词：动脉自旋标记 颅脑病变 脑灌注 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]