3D ASL与DSC-PWI定量参数在脑胶质瘤术前分级诊断中的应用研究  

Application of 3D ASL and DSC-PWI quantitative parameters in preoperative grading diagnosis of glioma

作　　者：李伟栋 张晓丹[2] 张超 许倩 徐凯 胡春峰 LI Weidong;ZHANG Xiaodan;ZHANG Chao;XU Qian;XU Kai;HU Chunfeng(Department of Medical Imaging,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China;Department of Medical Imaging,Huai'an First People's Hospital,Huai'an,Jiangsu 223300)

机构地区：[1]徐州医科大学附属医院影像科,江苏徐州221002 [2]淮安市第一人民医院影像科,江苏淮安223300

出　　处：《徐州医科大学学报》2022年第10期731-736,共6页Journal of Xuzhou Medical University

基　　金：徐州市卫生健康委员会青年医学科技创新项目(XWKYHT20210586);江苏省委组织部2019江苏双创博士基金(2019204006);徐州医科大学校级课题(2012KJ25)。

摘　　要：目的探讨三维动脉自旋标记成像(3D ASL)和动态磁敏感对比增强灌注加权成像(DSC-PWI)定量参数对脑胶质瘤术前分级的诊断价值及相关性。方法回顾性分析39例脑胶质瘤患者的影像学资料,对3D ASL脑血流量(ASL-CBF)、DSC-PWI脑血流量(DSC-CBF)、DSC-PWI脑血容量(DSC-CBV)及其相对值进行记录和分析。结果ASL-CBF、DSC-CBF、DSC-CBV及其相对值随着胶质瘤级别增加有所升高,ASL-CBF、DSC-CBF之间及ASL-相对脑血流量(ASL-rCBF)、DSC-rCBF之间呈明显正相关,而ASL-CBF、DSC-CBV之间及ASL-rCBF和DSC-相对脑血容量(DSC-rCBV)之间呈中等度正相关,ASL-CBF、DSC-CBF以及DSC-CBV值及相对值与病理级别之间均呈明显正相关。ROC曲线下面积最大参数为DSC-rCBF,其次是DSC-rCBV、ASL-rCBF。结论3D ASL与DSC-PWI定量参数在评估脑胶质瘤血流灌注方面均有较高的敏感度和特异度,均可用于脑胶质瘤的术前血流动力学评估。3D ASL简便易行,可有效评估脑胶质瘤术前分级。Objective To evaluate the value and the relevance of three-dimensional arterial spin labeling imaging(3 D ASL)and dynamic susceptibility contrast perfusion weighted imaging(DSC-PWI)in preoperative grading of brain glioma.Methods A total of 39 brain glioma patients were enrolled and their imaging materials were retrospectively analyzed.Their 3 D ASL cerebral blood flow(ASL-CBF),DSC cerebral blood flow(DSC-CBF),DSC cerebral blood volume(DSC-CBV)and the relative values were recorded.Results ASL-CBF,DSC-CBF,DSC-CBV and relative values increased with the increase of tumor grade.There was significant positive correlations between ASL-CBF and DSC-CBF,as well as between ASL-rCBF and DSC-rCBF.There was a moderate positive correlation between ASL-CBF and DSC-CBV,as well as between ASL-rCBF and DSC-rCBV.ASL-CBF,DSC-CBF,DSC-CBV and their relative values had a significant positive correlation with their pathological grades.A ROC curve was plotted and the largest AUC was for DSC-rCBE,followed by DSC-rCBV,and ASL-rCBF.Conclusions Both 3 D ASL and DSC-PWI quantitative parameters have high sensitivity and specificity in evaluating blood perfusion in glioma,and can be used for preoperative hemodynamic evaluation of glioma.3 D ASL is simple and easy to perform,and can effectively assess the preoperative grading of glioma.

关 键 词：磁共振灌注加权成像 动脉自旋标记 动态磁敏感对比增强 胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤]