快速动脉自旋标记成像在脑胶质瘤中的临床应用价值  

Clinical application value of rapid arterial spin labeling imaging in brain glioma

作　　者：张艳玲 徐慕榕 徐晓璐 丁金立 段云云 刘亚欧 江裕华[3] 卓芝政 Zhang Yanling;Xu Murong;Xu Xiaolu;Ding Jinli;Duan Yunyun;Liu Yaou;Jiang Yuhua;Zhuo Zhizheng(Department of Radiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Institute of Health Service and Transfusion Medicine,Academy of Military Medical Sciences,Academy of Military Sciences,Beijing 100850,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院放射科,北京100070 [2]军事科学院军事医学研究院卫生勤务与血液研究所,北京100850 [3]首都医科大学附属北京天坛医院神经外科,北京100070

出　　处：《中华放射学杂志》2024年第5期529-533,共5页Chinese Journal of Radiology

摘　　要：目的探讨快速动脉自旋标记(ASL)成像应用于脑胶质瘤成像的可行性。方法前瞻性纳入2021年5月至2022年12月就诊于首都医科大学附属北京天坛医院的脑胶质瘤患者,所有患者均接受MR快速ASL(扫描时间1 min)和常规ASL(扫描时间4 min 30 s)检查,得到脑血流分数(CBF)图。由2名放射科医师独立对2种序列扫描所得的CBF进行定性(人工判读肿瘤区CBF信号的高低)和定量分析(提取肿瘤实体区和水肿区等区域CBF平均值)。采用Kappa检验对定性评估结果进行一致性分析;采用ICC对定量结果进行一致性分析。结果共纳入脑胶质瘤患者30例。2名医师采用快速ASL判断肿瘤区低灌注、等灌注、高灌注分别为1、6、23例和0、5、25例;采用常规ASL判断肿瘤区低灌注、等灌注、高灌注均为0、9、21例;快速ASL与常规ASL定性分析的一致性均较高(Kappa分别为0.830、0.850)。定量分析显示,快速ASL与常规ASL测量脑不同部位的CBF值具有较高一致性(ICC为0.940~0.994)。结论快速ASL可替代常规ASL用于脑胶质瘤组织灌注评估,有助于胶质瘤的临床诊断。Objective To investigate the feasibility and clinical diagnostic value of rapid arterial spin labeling(ASL)imaging in brain glioma.Methods Patients with glioma admitted to Beijing Tiantan Hospital,Capital Medical University from May 2021 to December 2022 were prospectively enrolled.All patients received MR rapid ASL(scan time:1 min)and conventional ASL(scan time:4 min 30 s),where the cerebral blood flow(CBF)perfusion maps were obtained.The qualitative analysis of CBF signal intensity and quantitative analysis of average CBF values from both tumor solid and edema regions were conducted by two radiologists independently.Kappa test and intraclass correlation coefficient(ICC)were used to analyze the consistency of qualitative and quantitative results,respectively.Results A total of 30 patients with brain glioma were included.The 2 physicians used rapid ASL to determine low perfusion,isoperfusion,and hyperperfusion in the tumor area in 1,6,23 cases and 0,5,and 25 cases,respectively;and used conventional ASL to determine low perfusion,isoperfusion,and hyperperfusion in the tumor area in 0,9,and 21 cases,respectively.The results of qualitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups(Kappa was 0.830 and 0.850 respectively).The results of quantitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups(ICC 0.940—0.994).Conclusion Rapid ASL with shorter scanning time could be applied in assessing tissue perfusion in brain glioma and contribute to the clinical diagnosis of gliomas.

关 键 词：磁共振成像 快速动脉自旋标记 脑胶质瘤 灌注成像 

分 类 号：R739.41[医药卫生—肿瘤]