ASL技术联合DWI在脑肿瘤术后检查中的应用  

Application of ASL technique combined with diffusion-weighted imaging in the examination of brain tumor after operation

作　　者：欧阳红斌 刘林林 陈瑞欢 许健恩 黄清善 李腾 OUYANG Hong-bin;LIU Lin-lin;CHEN Rui-huan;XU Jian-en;HUANG Qing-shan;LI Teng(Department of Medical Imaging,Foshan Fuxing Chancheng Hospital,Foshan 528011,Guangdong,CHINA)

机构地区：[1]佛山复星禅诚医院医学影像科,广东佛山528011

出　　处：《海南医学》2024年第2期262-265,共4页Hainan Medical Journal

基　　金：广东省佛山市科学技术局项目(编号:2220001003942)。

摘　　要：目的探讨动脉自旋标记灌注成像(ASL)技术联合扩散加权成像(DWI)在脑肿瘤术后检查中的应用价值。方法回顾性分析2020年3月至2023年2月在佛山复星禅诚医院进行术后检查的58例脑肿瘤患者的临床资料,依据随访或二次手术病理结果分为肿瘤复发组34例和胶质增生组24例,所有患者均接受常规磁共振扫描和ASL、DWI检查,对肿瘤灌注最显著区域及对侧正常脑实质的脑血流量(CBF)进行测量,计算相对CBF (rCBF),并对肿瘤实质强化边缘外1 cm内水肿区域的平均表观扩散系数(ADC)进行测量。比较两组患者的rCBF、ADC,绘制受试者工作特征曲线(ROC)分析rCBF、瘤周1 cm内ADC及两者联合对胶质增生及脑肿瘤复发的诊断效能。结果脑肿瘤复发组患者的rCBF水平为3.59±0.46,明显高于胶质增生组的0.93±0.25,瘤周1 cm内ADC为(1.30±0.25)×10^(-3)mm^(2)/s,明显低于胶质增生组的(1.53±0.18)×10^(-3)mm^(2)/s,差异均有统计学意义(P<0.05);经ROC分析结果显示,rCBF联合瘤周1 cm内ADC诊断胶质增生及脑肿瘤复发的灵敏度与特异度分别为96.80%、92.45%,明显高于rCBF、瘤周1 cm内ADC单独诊断的84.44%、87.52%与89.83%、78.18%,差异均有统计学意义(P<0.05)。结论ASL技术联合DWI应用于脑肿瘤术后检查中可准确评估肿瘤复发与胶质增生,且不需要注射对比剂,安全无创,具有较大的临床价值。Objective To investigate the application value of arterial spin-labeled perfusion imaging(ASL)combined with diffusion-weighted imaging(DWI)in the examination of brain tumor after surgery.Methods The clini-cal data of 58 patients with brain tumor who underwent postoperative examination in Foshan Fuxing Chancheng Hospi-tal from March 2020 to February 2023 were retrospectively analyzed.The patients were divided into tumor recurrence group(34 cases)and gliosis group(24 cases)according to the pathological results of follow-up or secondary operation.All patients received routine magnetic resonance scanning,ASL,and DWI examination.Cerebral blood flow(CBF)in the most significant area of tumor perfusion and the contralateral normal brain parenchyma was measured,and the rela-tive CBF(rCBF)was calculated.The average apparent diffusion coefficient(ADC)of the edema area within 1 cm out-side the enhanced edge of tumor parenchyma was measured.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of rCBF,ADC within 1 cm around the tumor,and their combination for gliosis and brain tumor recurrence.Results The rCBF level of the tumor recurrence group was 3.59±0.46,which was significantly higher than 0.93±0.25 of the gliosis group;the ADC within 1 cm of the tumor was(1.30±0.25)×10^(-3)mm^(2)/s,which was significantly lower than(1.53±0.18)×10^(-3)mm^(2)/s of the gliosis group;the differences were statistically significant(P<0.05).ROC analysis results showed that the sensitivity and specificity of rCBF combined with ADC in the diagnosis of gliosis and brain tumor recurrence were 96.80%and 92.45%,which were significantly higher than 84.44%,87.52%of rCBF and 89.83%,78.18%of ADC alone(P<0.05).Conclusion The application of ASL technique in combination with DWI in the postoperative examination of brain tumors can accurately assess tumor recurrence and gliosis,and does not require injection of contrast agent,which is safe and non-invasive,and has great clinical value.

关 键 词：脑肿瘤 动脉自旋标记灌注成像 扩散加权成像 相对脑血流量 表观扩散系数 

分 类 号：R739.41[医药卫生—肿瘤]