3DASL检查在高和低级别胶质瘤患者鉴别诊断中的应用价值

The value of 3DASL examination in differential diagnosis of high and low grade glioma patients

目的分析三维动脉自旋标记法(Three-dimension alarterial spin labeling,3DASL)检查在高、低级别胶质瘤患者鉴别诊断中的临床应用价值。方法选取2016年12月至2018年2月本院36例脑胶质瘤患者作为研究对象,术前均给予3DASL、常规磁共振灌注成像(MR)、MR脑灌注~动态磁敏感对比成像(DSC)。对比分析3DASL、DSC产生的肿瘤实质部分最大相对血流量(rTBFmax)在不同级别胶质瘤间的差异。结果3DASL法与DSC法中,高级别胶质瘤rTBFmax高于低级别胶质瘤(P<0.05);DSC法与3DASL法rTBFmax值比较,差异无统计学意义;常规MRI与常规MRI+3DASL诊断符合率比较,差异无统计学意义。结论3DASL作为肿瘤病变灌注成像的全新解决方案,可有效用于胶质瘤术前诊断与分级,评估肿瘤生长快慢等生物学行为,同时病变灌注信息也可辅助术前制定正确的手术方案与风险防范措施。

Objective To analyze the clinical value of three-dimensional arterial labeling (3DASL) in the differential diagnosis of high and low grade glioma patients. Methods Thirty-six patients with glial cells from December 2016 to February 2018 were enrolled in the study. All patients were given 3DASL, conventional magnetic resonance perfusion imaging (MR), MR cerebral perfusion-dynamic magnetic sensitive contrast imaging (DSC). The differences in the maximum relative blood flow (rTBFmax) of tumor parenchyma produced by 3DASL and DSC in different grades of glio-ma were compared and analyzed. Results In the 3DASL and DSC methods, the rTBFmax of high-grade glioma was higher than that of low-grade glioma (P<0.05). There was no significant difference between the DSC method and the 3DASL rTBFmax value. Conventional MRI and The diagnostic accuracy of conventional MRI+ 3DASL was not statistically significant. Conclusion As a new solution for tumor lesion perfusion imaging, 3DASL can be effectively used for preoperative diagnosis and grading of glioma, to evaluate the biological behavior such as tumor growth rate, and the perfusion information can also help to develop correct surgical plan and risk before surgery.