三维动脉自旋标记联合弥散加权成像在脑胶质瘤术前分级诊断中的应用价值

Application value of three-dimensional arterial spin labeling combined with DWI in preoperative grading diagnosis of glioma

目的:研究三维动脉自旋标记(3D-ASL)联合弥散加权成像(DWI)在脑胶质瘤(BG)术前分级诊断中的应用价值。方法:回顾性分析BG患者142例,根据患者病情分为低级别BG组和高级别BG组。对所有BG患者均进行DWI和3D-ASL扫描。对两组的DWI参数(ADC、rADC)、3D-ASL参数(TBF、rTBF)进行比较。使用受试者工作(ROC)曲线,分别对DWI、3D-ASL以及DWI联合3D-ASL对BG术前分级的诊断价值进行分析。结果:高级别BG组患者的ADC和rADC明显低于低级别BG组(P<0.05);高级别BG组患者的TBF和rTBF均明显高于低级别BG组(P<0.05);ROC曲线分析可得AUCrADC+rTBF>AUCrTBF>AUCTBF>AUCrADC>AUCADC+TBF>AUCADC。rADC+rTBF的AUC为0.934,截断值下的灵敏度为92.30%,特异度为96.90%,优于其他参数。结论:DWI和3D-ASL均可作为BG术前分级诊断中的重要无创检测手段,与DWI相比,3D-ASL在BG术前分级中的诊断价值更高,联合应用DWI和3D-ASL下,能够实现两种诊断方法的优势互补,使诊断价值进一步提高。

Objective:To study the application value of three-dimensional arterial spin labeling(3 D-ASL) combined with diffusion weighted imaging(DWI) in preoperative grading diagnosis of brain glioma(BG).Methods:Retrospective analysis of 142 BG patients were conducted,and the patients were divided into low-grade BG group and high-grade BG group according to their condition.DWI and 3 D-ASL scans were performed on all BG patients.The DWI parameters(ADC,rADC) and 3 D-ASL parameters(TBF,rTBF) of the two groups were compared.The receiver operating curve(ROC) was used to analyze the diagnostic value of DWI,3 D-ASL,and DWI combined with 3 D-ASL for BG preoperative classification.Results:The ADC and rADC of patients in the high-grade BG group were significantly lower than those in the low-grade BG group(P<0.05).The TBF and rTBF of patients in the high-grade BG group were significantly higher than those in the low-grade BG group(P<0.05).In the ROC curve analysis results,AUCrADC+rTBF>AUCrTBF>AUCTBF>AUCrADC>AUCADC+TBF>AUCADC.The AUC of rADC+rTBF was 0.934,the sensitivity under the cutoff value was 92.30%,and the specificity was 96.90%,which was better than other parameters.Conclusion:Both DWI and 3 D-ASL can be used as important non-invasive detection methods in the preoperative classification of BG.Compared with DWI,3 D-ASL has higher diagnostic value in the preoperative classification of BG.The combined application of DWI and 3 D-ASL can realize the complementary advantages of the two diagnostic methods,and further improve the diagnostic value.