脑胶质瘤分级诊断的新方法:动脉自旋标记技术

A new method for differential diagnosis between high grade gliomas and low grade gliomas:arterial spin labeling

目的评价动脉自旋标记(ASL)技术在高、低级别胶质瘤鉴别诊断的研究价值和临床意义。方法选择手术及病理证实的大脑胶质瘤27例,其中高级别胶质瘤14例,低级别胶质瘤13例,术前使用3.0TMRI成像系统行常规扫描,加扫可一次采集多层的第二版本Q2TIPS的ASL序列,观测所得相对脑血流量(CBF)图,使用SPSS13.0软件进行数据分析。结果高级别胶质瘤的血流量灌注(132.59±13.36)ml/(min.100g)和低级别胶质瘤的血流灌注(102.72±4.50)ml/(min.100g)间有显著性差异(P<0.01)。数据转换后,高、低级胶质瘤肿瘤血流量(TBF)/对侧灰质CBF的值分别为1.16±0.15和0.96±0.06,P<0.01;TBF/对侧白质CBF的值分别为1.26±0.15和1.05±0.07,P<0.01;TBF/对侧半球CBF的值分别为1.12±0.12和0.93±0.06,P<0.01。结论ASL可用于大脑胶质瘤微血管灌注的评估,有助于高、低级别胶质瘤的鉴别诊断。

Objective To evaluate the value of arterial spin labeling （ASL） in differential diagnosis between high grade gliomas and low grade gliomas. Methods Twenty-seven patients with gliomas confirmed by operation and pathology included 14 cases of high grade gliomas and 13 cases of low grade gliomas. All patients were routinely examined by 3.0-T MRI including pulsed ASL with Q2TIPS （ second version of quantitative imaging of perfusion by using a single subtraction with addition of thin-section periodic saturation after inversion and a time delay） technique before operation. Relative cerebral blood flow （CBF） was computed and analyzed in target regions. Statistical analysis was performed using SPSS 13.0. Results ASL showed there was statistical difference between high blood flow perfusion in high grade gliomas [ （ 132.59± 13.36） ml/ （min · 100 g）] and low blood flow perfusion in low grade gliomas [ （102.72 ±4.50） ml/ （ min·100 g） ] （ P 〈 0.01 ）. In high grade gliomas and low grade gliomas, the rate of tumor blood flow （TBF）/opposite grey matter CBF was 1. 16 ±0. 15 and 0.96 ±0, 06 （P 〈0.01 ） ; TBF/opposite white matter CBF was 1.26 ±0. 15 and 1.05 ±0.07 （P 〈0. 01 ） ; TBF/opposite hemisphere CBF was 1. 12 ±0.12 and 0.93 ±0. 06 （ P 〈0.01 ）, respectively. Conclusion ASL will be a suitable method for the evaluation of mierovascular perfusion and the differential diagnosis of glionms.