三维动脉自旋标记与磁共振动态对比增强成像参数在胶质瘤术前分级中的对照研究  

Comparative study of three dimensional pseudo-continuous arterial spin labeling and dynamic contrastenhanced MRI parameters in preoperative grading of gliomas

作　　者：李锐[1] 刘晋红[2] 王玉林[1] 娄昕[1] 马林[1] 

机构地区：[1]解放军总医院放射科,北京100853 [2]解放军总医院病理科,北京100853

出　　处：《肿瘤影像学》2016年第3期217-222,共6页Oncoradiology

摘　　要：目的:对照研究三维动脉自旋标记(arterial spin labeling,ASL)与磁共振动态对比增强成像(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)参数在术前脑胶质瘤诊断中的特点。方法:回顾分析2014年7月—2016年5月经病理证实的胶质瘤39例(其中高级别胶质瘤23例、低级别胶质瘤16例),所有患者均行常规MRI、ASL及DCE-MRI检查,运用GE开发工作站Omni-Kinetics Version 2.0获得容积转运常数(volume transfer constant,Ktrans)、血管外细胞外间隙容积比(extravascular extracellular space volume fraction,Ve)、血浆容积分数(fractional plasma volume,Vp)、肿瘤血容量(tumor blood volume,TBV)及肿瘤血流量(tumor blood flow,TBF);ASL应用GE ADW4.6工作站获得脑血流量(cerebral blood flow,CBF),测得病变的最大CBF及对侧正常脑组织的CBF,分别比较不同级别胶质瘤Ktrans、Ve、Vp、r TBF-DCE及r CBF-ASL之间的差异,并分析r TBF-DCE与r CBF-ASL之间的相关性。结果:与低级别胶质瘤相比,高级别胶质瘤的Ktrans、Ve、Vp、r TBF-DCE、r CBF-ASL值分别为(0.162±0.026)/min、0.810±0.194、0.118±0.026、2.876±0.236、2.574±0.160,均高于低级别胶质瘤的(0.023±0.007)/min、0.463±0.099、0.055±0.017、1.684±0.174、1.163±0.048,且r TBF-DCE与r CBF-ASL之间存在一定相关性(r=0.62,P<0.05)。结论:基于DCE-MRI获得的定量参数Ktrans、Ve、Vp、r TBF与基于ASL获得的定量参数r CBF可用于术前区分高级别与低级别胶质瘤。Objective: To comparatively study the difference between three dimensional pseudo-continuous arterial spin labeling(3D p CASL) and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) in the features of assessing the preoperative grading of gliomas. Methods: The data of 39 patients with proved gliomas(23 with high-grade gliomas and 16 with low-grade gliomas) from July 2014 to May 2016 were retrospectively analyzed. All patients were scanned on a 3.0T MRIsystem using conventional sequences, 3D p CASL and DCE sequence. DCE-MRI parameters such as volume transfer constant(Ktrans), extravascular extracellular space volume fraction(Ve), fractional plasma volume(Vp), tumor blood flow(TBF) and tumor blood volume(TBV) and 3D p CASL parameter cerebral blood flow(CBF) were measured and analyzed in different grades of gliomas, respectively using Omni-Kinetics Version 2.0 workstation and GE Advantage 4.5 workstation. Relative TBF(r TBF) and r CBF were obtained based on normalized mirror region and contralateral white matter. A correlation between r TBF on DCEMRI and r CBF on 3D p CASL was noted. Results: The differences in Ktrans, Ve, Vp, r TBF and r CBF values [(0.162±0.026)/min vs.(0.023±0.007)/min, 0.810±0.194 vs. 0.463±0.099, 0.118±0.026 vs. 0.055±0.017, 2.876±0.236 vs. 1.684±0.174, 2.574±0.160 vs.1.163±0.048] were statistically significant between high-grade glioma and low-grade glioma. There was certain correlation between r TBF on DCE-MRI and r CBF on 3D p CASL(r=0.62, P<0.05). Conclusion: DCE-MRI parameters(Ktrans, Ve, Vp and r TBF) and ASL parameter(r CBF) might be useful in differentiating the preoperative grading of gliomas.

关 键 词：胶质瘤分级 动脉自旋标记 磁共振动态对比增强成像 微血管渗透性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]