摘要
目的探讨动脉质子自旋标记(ASL)与动态磁敏感对比增强(DSC)灌注技术用于脑胶质瘤分级的可行性。方法经病理证实的28例脑胶质瘤患者,按世界卫生组织2000年规定的胶质瘤分级标准分为高级15例,低级13例。使用3.0 T MR 扫描仪进行 Q2TIPS 的 ASL 检查和静脉团注钆喷替酸葡甲胺(Gd-DTPA)的 DSC 灌注检查。所得数据经两独立样本秩和检验分析,P<0.05为差异有统计学意义;并用直线回归的方法分析两种灌注方法的相关性。结果 ASL 法测得的脑胶质瘤血流量(TBF)/对侧脑白质相对血流量(CBF):高、低级别胶质瘤分别为(5.5±1.8)、(2.1±1.4),DSC 法测得的值分别为(4.3±1.0)、(2.0±1.1),差异均有统计学意义(Z 值分别为-3.824、-3.939,P<0.01);ASL 法测得的 TBF/对侧半球 CBF 值,高、低级别胶质瘤分别为(2.2±0.8)、(0.8±0.5),DSC 法测得的值分别为(2.1±0.8)、(1.0±0.6),差异均有统计学意义(Z 值分别为-3.987、-3.386,P<0.01);ASL 法测得的 TBF/对侧灰质 CBF 值,高、低级别胶质瘤分别为(1.7±0.6)、(0.7±0.5),DSC 法测得值分别为(1.6±0.5)、(0.8±0.4),差异均有统计学意义(Z 值分别为-3.894、-3.754,P<0.01)。两种方法测得的上述比值均密切相关(r 分别为0.91、0.93、0.91,P<0.01)。结论 ASL 可用于胶质瘤微血管灌注的评估,有助于区分低级别和高级别脑胶质瘤。
Objective To implement an arterial spin labeling （ASL） technique and to test the method and compare it with first-pass dynamic susceptibility-weighted contrast-enhanced （ DSC ） magnetic resonance imaging for evaluation of tumor blood flow （TBF） in patients with brain gliomas. Methods Twenty-eight patients with histologically proven gliomas were examined at a clinical 3.0 T MR imaging unit. A second version of quantitative imaging of peffusion by using a single subtraction with addition of thinsection periodic saturation after inversion and a time delay （ Q2TIPS ） technique of pulsed arterial spin labehng in the multisection mode was implemented. After arterial spin labeling, a T2 -weighted first-pass bolus perfusion study （ Gd-DTPA, 0. 2 mmol/kg, 5 ml/s） was performed by using a gradient-echo echoplanar imaging sequence. In regions of interest, maps of relative cerebral blood flow （CBF） were computed and analyzed with ASL and DSC MR imaging, respectively. Statistical analysis was performed by using SPSS 10. 0. Results TBF/contralateral white matter CBF determined with ASL in high- and low-grade gliomas was respectively （5.5 ±1.8 ）, （ 2. 1 ± 1.4 ） ; and that determined with DSC was （4. 3 ±1.0 ）, （ 2. 0 ± 1.1 ）. TBF/contralateral hemisphere CBF with ASL and DSC in high- and low-grade gliomas was respectively （2.2±0.8）, （0.8± 0.5）, （2. 1±0.8） and （l. 0± 0.6）. These four corresponding ratios of TBF/contralateral gray matter CBF was （ 1.7 ± 0. 6 ）, （ 0. 7 ± 0. 5 ）, （ 1.6± 0. 5 ） and （ 0. 8 ± 0. 4 ）. Statistical analysis demonstrated high- and low-grade ghomas differed significantly （ P 〈 0. 01 ） in terms of the ratios of relative CBF determined with ASL and DSC. There was a close linear correlation between beth methods, and linear regression coefficients of TBF/CBF of contralateral white matter, hemisphere and gray matter was respectively 0. 91, 0. 93 and 0. 91 （ P 〈 0. 01 ）. Conclusions The arterial spin labeling is a suitable method for assessment of microvascular perfusion and allows distinction between high- and low-grade gliomas.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2007年第4期363-365,共3页
Chinese Journal of Radiology
