3D-ASL在胶质瘤术前分级的应用价值

The Value of 3D-ASL in the Preoperative Grading of Gliomas

目的探讨三维动脉自旋标记成像(3D-ASL)的在胶质瘤术前分级的价值。方法收集手术后病理证实为胶质瘤病人18例,其中低级别(Ⅰ-Ⅱ级)的8例,高级别(Ⅲ-Ⅳ级)10例,术前每例均作头颅MRI常规平扫及增强扫描、3D-ASL,重建脑血流量图(CBF),对照增强扫描,避开肿瘤坏死囊变区和血管,置感兴趣区ROI于肿瘤实性成分,ROI测量面积20-30mm2,测量每例肿瘤CBF和镜像区CBF,相对脑血流量rCBF=肿瘤CBF/镜像区CBF,样本作t检验,比较高、低级别胶质瘤的rCBF的差异。结果高级别胶质瘤rCBF值(2.65±0.82)高于低级别胶质瘤rCBF(1.64±0.63),两组之间具有统计差异(t=4.32,P<0.01)。结论 3D-ASL在胶质瘤术前分级有较高的准确性,有利于指导临床制定治疗方案。

Objective To discuss the value application of 3D-ASL in the preoperative grading of gliomas. Methods Collect 18 cases of patients with glioma proved by pathology after surgery, including 8 cases of low grade （Ⅰ-Ⅱgrade） and 10 cases of high grade （Ⅲ-Ⅳ grade）. Each patient were scaned on routine head MRI, enhanced scan, 3D-ASL before operation and reconstruct cerebral blood flow diagram （CBF） figure. According to the enhanced scanning we should avoid the areas of necrosis sac and vascular of the tumor and focus ROI on the material composition, which coverd 20-30mm2. Measuring the solid part of CBF and the mirror region of CBF in each case and make the ratio, tumor CBF/image CBF to work out the rCBF. Then compared the two samples with t test in order to distinguish the difference between rCBF in the high and low grading of gliomas.Results The value of rCBF is （2.65±0.82） in high grade gliomas was higher than the value of rCBF （1.64±0.63） in low grade gliomas. The difference between the two groups was statistical significantly （t=4.32,P〈0.01）. Conclusion 3D-ASL has high accuracy in the preoperative grading of gliomas, which is helpful for guiding clinical treatment.