三维动脉自旋标记技术在脑肿瘤中的应用价值

The application value of 3-dimensional arterial spin labeling technology in brain tumors

目的 研究三维动脉自旋标记技术（3D-ASL）在脑肿瘤中的临床应用价值.方法 选择20例经病理确诊的脑肿瘤患者作为研究对象,其中低级别胶质瘤4例,高级别胶质瘤2例,淋巴瘤1例,转移瘤7例,脑膜瘤6例.所有患者术前均应用3D-ASL及动态磁敏感对比增强灌注（DSC）技术两种方法行MR成像,以分析3D-ASL在脑肿瘤中的应用价值.结果 3D-ASL在脑肿瘤患者病灶中可以显示高灌注或低灌注;3D-ASL及DSC技术两种方法测得的肿瘤组织血供——局部相对脑血流量（rCBF）比较差异无统计学意义（P＞0.05）;在3D-ASL图像上高级别胶质瘤显示高灌注,rCBF为3.0±1.3;低级别胶质瘤显示低灌注,rCBF为0.6±0.2,比较差异有统计学意义（P＜0.01）.转移瘤显示环形高灌注,中心坏死及周边水肿区低灌注;淋巴瘤显示稍高灌注;脑膜瘤显示高灌注,且rCBF最高,为3.5±1.9.结论 3D-ASL在脑肿瘤的诊断中,具有重复性高、非侵入性、无需对比剂等特点.3D-ASL可进一步发展成为脑肿瘤血流动力学的常规评估方法,并可用于脑肿瘤级别的评估,拥有广泛的应用前景.

Objective To study the clinical application of 3-dimensional arterial spin labeling technology （3D-ASL） in brain tumors.Methods Twenty patients with the pathological diagnosis of brain tumors were selected in this study,with low grade glioma in 4 cases,the high grade glioma in 2 cases,lymphoma in 1 case,metastatic tumor in 7 cases,meningioma in 6 cases.All patients were appLIed preoperative 3D-ASL and dynamic contrast-enhanced perfusion magnetic sensitive （DSC） MR imaging line two methods,to analyze the value of 3D-ASL in brain tumors.Results 3D-ASL examination lesions in patients with brain tumors might be displayed in high or low perfusion; 3D-ASL and DSC were obtained from tumor tissue blood supply,the local relative cerebral blood flow （rCBF）,there was no significant difference （P 〉 0.05）.The high grade glioma in 3D-ASL image showed a high perfusion,rCBF was 3.0 ± 1.3; Low grade gliomas showed low perfusion,rCBF was 0.6 ± 0.2,the rCBF between the high-and low-grade gliomas was significantly different （P 〈 0.01）.Metastatic tumor 3D-ASL showed ring high perfusion,central necrosis and edema area of low perfusion.Lymphoma 3D-ASL showed slightly higher perfusion.Meningioma showed high perfusion,and highest rCBF,3.5 ± 1.9.Conclusions 3D-ASL in the diagnosis of brain tumors,has high repeatability,non-invasive,without contrast agent.3D-ASL can be further developed into the brain blood flow dynamics of conventional evaluation methods,and can be used for brain tumors level assessment,has broad application prospects.